MS Thesis Presentation by Carmen M. Greene
Tuesday, October 23, 2005

(Dr. Nolan Hertel , Chair)

"Experience Using a Small Field of View Gamma Camera for Intraoperative Sentinel Lymph Node Procedures"

Abstract

Sentinel lymph node (SLN) biopsy is now standard practice in the management of many breast cancer and melanoma patients. Before sentinel lymph node biopsies became standard practice, surgeons performed full axillary or regional dissections on patients, although the benefits were not clear for many patients. Sentinel lymph node biopsies spare many patients the morbidity and discomfort associated with a full axillary or regional dissection. Localization protocols for SLN biopsy vary in complexity and rates of success. The least complex involve only intraoperative gamma counting of radiotracer uptake or intraoperative visualization of blue-dye uptake; the most complex involve preoperative gamma imaging, intraoperative counting and intraoperative dye visualization. It is possible that adding intraoperative gamma imaging may improve some protocols for a SLN biopsy. This study was conducted to obtain preliminary experience and information on a small field of view gamma camera used for intraoperative imaging in sentinel lymph node surgeries. Patients that were already scheduled to have sentinel lymph node surgery were enrolled in a protocol that included intraoperative counting and dye visualization (probe/dye), or a protocol that involved intraoperative imaging, counting and dye visualization (camera/probe/dye). The studies were done under IRB approved protocols for Emory University Health Care, Atlanta Veterans Affair Medical Center and Georgia Institute of Technology.