Supported by SurgicEye's 3-D imaging and navigation solution declipseSPECT, the breast surgeons at Klinikum rechts der Isar in Munich, Germany performed a study for objective quality assurance and documentation during sentinel lymph node biopsy (SLNB). The preliminary results show higher sensitivity in comparison to the use of gamma probes alone. The group will launch soon a multicenter study to confirm the results.

Sentinel lymph node (SLN) mapping based on Tc99m is routinely applied in breast cancer and leads in combination with blue dye to the highest sensitivity in the detection of SLNs. The intra-operative localization of SLNs is based on the gamma probe localization of the radioactivity. At the Department of Gynecology at Klinikum rechts der Isar in Munich, SurgicEye's novel 3D Imaging and Navigation technique was used in a feasibility study to demonstrate the functionality of the device as well as its increased sensitivity of intra-operative SLN mapping compared to the sole use of conventional gamma probes. Preliminary results will be presented by Dr. Andreas Schnelzer during the San Antonio Breast Cancer Symposium (Dec 08-12, 2010): “Using freehand SPECT for 3D navigated radio-guided axillary sentinel lymph node biopsy and quality assurance in breast cancer surgery” (P1-01-22).

In the study, after radioactive lymph nodes detected by a gamma probe were resected, declipseSPECT was capable of detecting additional radioactive nodes in 8 of 14 patients. These preliminary results confirmed what Prof. Marion Kiechle envisioned when the 3D intra-operative imaging and navigation technology of SurgicEye was invented. “This innovative technology will support the detection of SLN in all dimensions and provides a quality assurance in the surgical treatment of breast cancer patients, ensuring that the optimal therapy is delivered to every individual patient”. Dr. Stefan Paepke, chief breast surgeon adds: “The SLN mapping for breast cancer is only the first step towards minimally invasive and safe oncologic surgery. Other gynecologic cancer can be treated analogue to the breast cancer SLN concept ensuring a more reliable staging – where the challenge lies in the depths and the planning of the access path”. As inventor of the ADAM technique for minimally invasive SLN resection, Dr. Paepke and his team are permanently improving the quality of care. Dr. Alexandra Ehlerding, resident surgeon in the Munich team, highlights the close cooperation between the clinic, engineering departments of Technische Universität München and SurgicEye and their interdisciplinary approach to achieve progress in the treatment of cancer patients.

Dr. Schnelzer, Dr. Paepke, and Dr. Ehlerding are at the moment recruiting centers for a multicenter study of the quality assessment in SLN mapping in breast, cervical and vulvar cancer using the 3-D SLN imaging and navigation for an objective documentation and archiving method. They believe that the 3-D imaging approach of SurgicEye will make the quality in terms of completeness and minimally invasiveness more reliable than probe based measurement. This will make an optimal treatment available for every woman.

References:

T. Wendler, K. Herrmann , A. Schnelzer, T. Lasser, J. Traub, O. Kutter, A. Ehlerding, K. Scheidhauer, T. Schuster, M. Kiechle, M. Schwaiger, N. Navab, S. I. Ziegler, A. K. Buck; First demonstration of 3-D lymphatic mapping in breast cancer using freehand SPECT; European Journal of Nuclear Medicine and Molecular Imaging; Volume 37, Number 8, Aug. 2010