Intraoperative lymph node evaluation using 18F-FDG and a hand-held gamma probe in endometrial cancer surgery--a pilot...

Area of Science:

• Oncology
• Nuclear Medicine
• Surgical Oncology

Background:

• High-risk endometrial cancer (EC) necessitates accurate staging for optimal treatment.
• Intraoperative assessment of lymph node metastasis is crucial for surgical planning and patient outcomes.

Purpose of the Study:

• To evaluate the feasibility, safety, and accuracy of a hand-held gamma probe for detecting metastatic lymph nodes during surgery in high-risk endometrial cancer patients.
• To assess intraoperative imaging with 18F-FDG using a gamma probe.

Main Methods:

• Prospective cohort study involving 7 eligible patients with high-risk endometrial cancer undergoing open surgery.
• 61 nodal stations assessed intraoperatively, in vivo, and ex vivo using a gamma probe.
• Adverse events and radiation exposure to operating room staff were monitored.

Main Results:

• The hand-held gamma probe was feasible and safe, with no adverse events reported.
• Radiation exposure to healthcare personnel was within safety guidelines (average 0.08 mSV/case).
• One metastatic node was detected, but intraoperative probe readings did not reliably distinguish metastatic from non-metastatic nodes.

Conclusions:

• Intraoperative use of a hand-held gamma probe is feasible and safe for staging high-risk endometrial cancer.
• Current data suggest the probe's utility for detecting lymph node metastases needs further research and validation.
• Radiation safety guidelines were maintained for healthcare professionals during the study.