IMR Press / EJGO / Volume 37 / Issue 3 / DOI: 10.12892/ejgo3102.2016

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Original Research
Intraoperative lymph node evaluation using 18F-FDG and a hand held gamma probe in endometrial cancer surgery - A pilot study
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1 Joint Department of Medical Imaging UHN-MSH-WCH, Princess Margaret Hospital, Toronto, Ontario, Canada
2 Princess Margaret Hospital, Division of Gynecologic Oncology, M700-Gynecologic Oncology, Toronto, Ontario, Canada
Eur. J. Gynaecol. Oncol. 2016, 37(3), 362–366; https://doi.org/10.12892/ejgo3102.2016
Published: 10 June 2016
Abstract

Purpose: The purpose of this pilot study was to assess feasibility, safety, and accuracy of detection of metastatic nodes intraoperatively with a hand-held gamma (PET) probe after administration of 18F-FDG in patients with high risk endometrial cancer (EC). Materials and Methods: This is a prospective, cohort study. Twenty-two patients with clinical Stage I or II EC with high-risk histologic subtypes who were candidates for open surgical intervention were screened for the study. After screening, there were seven study patients (mean age: 64; range: 53-77) who were eligible for the study. In the entire cohort, there were 61 nodal stations that were assessed with a gamma counter intraoperatively, in vivo and again after removal of the node. All adverse events were recorded and operating room staff was monitored for radiation exposure. Resected nodes underwent histological assessment as per routine clinical practice. Results: Range of maximal counts per second recorded in vivo and ex vivo were 0-86 and 0-17, respectively. Of all the nodes examined, one node was positive for metastatic disease; however, intraoperatively the lymph node readings were not higher than other lymph node basins assessed in same patient. No adverse events were recorded. The surgeons recorded the maximum average radiation exposure of all healthcare personnel with an average exposure of 0.08 mSV per case (range, 0.06-0.15). Conclusion: Use of hand-held gamma probe for intraoperative staging of patients with high risk EC is feasible, safe, and radiation exposure levels for all members of the healthcare team were within radiation safety guidelines. However, its use for detection of lymph node metastases needs further evaluation.
Keywords
Lymph nodes
18F-FDG
Endometrial cancer
Gamma probe
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