Non-surgical SLNB: SentiGuide®

Outpatient, Preoperative Sentinel Lymph Node Biopsy

SentiGuide allows a preoperative mapping of the sentinel lymph node to enable needle biopsy. This is achieved by augmenting a high-resolution 3D SPECT image on the ultrasound image and then performing an ultrasound guided needle biopsy instead of extracting the sentinel lymph node by means of surgery.





How does SentiGuide work?

The SentiGuide generates SPECT images using a highly sensitive handheld gamma camera combined with an optical navigation system. By scanning around the region of interest, data is captured and used to reconstruct a high-resolution SPECT image. This image is then overlayed on the ultrasound image and lets the user easily identify the SLNB. The registration of both images is done completely automatic by using a common reference sensor. In the final step a needle biopsy under ultrasound guidance is performed.

Video demonstrating the clinical setup and workflow of SentiGuide

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Reduced OR time

since the status of the sentinel lymph node is known beforehand. Main surgery and ALND (if indicated) can be done all in one. No waiting time for the frozen section during surgery.

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Reduced complication rate

for the preoperative SLNB compared to the normal surgical approach.

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No stand-alone SLNB

for patients that get a neoadjuvant chemo therapy.

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Patient dose reduction by factor of 4

since preoperative SLNB can be done shortly after injection. No 2-day protocol needed.

Literature about SentiGuide

  • Asli Okur et al. fhSPECT-US Guided Punch Biopsy of Sentinel Lymph Nodes in the Axilla: Is it Feasible? in Medical Image Computing and Computer-Assisted Intervention–MICCAI 2014
  • Wiesner, S. et al. Registration free SPECT and Ultrasound Imaging. in SMIT Proceedings (2011)
  • Wendler, T., Ziegler, S. I., Scheidhauer, K., Lasser, T. & Navab, N. Freehand SPECT/US: new approach for intraoperative hybrid imaging of sentinel nodes. in ISNS 2010
  • Wendler, T., Lasser, T., Ziegler, S. & Navab, N. Freehand SPECT / ultrasound fusion for hybrid image-guided resection. in Eur J Nucl Med Mol Imaging 36, S158–S193 (2009)