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Jeffrey E. Lee - One of the best experts on this subject based on the ideXlab platform.
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Potential role for intraoperative Gamma Probe identification of normal parathyroid glands.
American Journal of Surgery, 2003Co-Authors: Lee C. Pederson, Suzanne E. Shapiro, Herbert A. Fritsche, Ebrahim Delpassand, Robert F. Gagel, Steven I. Sherman, Rena Vassilopoulou-sellin, Douglas B. Evans, Jeffrey E. LeeAbstract:Abstract Background Patients undergoing central neck surgery are at risk for hypoparathyroidism. We hypothesized that Gamma Probe identification of sestamibi-labeled parathyroid glands might help maximize parathyroid preservation. Methods Records of 351 patients who underwent central neck surgery were reviewed. A subgroup of patients underwent sestamibi injection followed by Gamma Probe-directed parathyroid gland identification. Results Operation was performed for malignancy in 73% of patients and represented a reoperation in 34%. Persistent hypoparathyroidism was more common in patients who underwent reoperation versus a primary operation (6.8% versus 1.7%; P = 0.02). Thirteen patients underwent Gamma Probe-directed identification of sestamibi-labeled parathyroid glands; in 6 of these patients, sestamibi-labeled parathyroid glands were salvaged from the resected specimens and autografted. None of these 13 patients developed persistent hypoparathyroidism. Conclusions Patients undergoing reoperative central neck surgery are at increased risk for postoperative hypoparathyroidism. Gamma Probe-directed salvage of sestamibi-labeled parathyroid glands may help maximize parathyroid preservation, especially in complex or reoperative central neck surgery.
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Scientific paper Potential role for intraoperative Gamma Probe identification of normal parathyroid glands
2003Co-Authors: Lee C. Pederson, Suzanne E. Shapiro, Herbert A. Fritsche, Ebrahim Delpassand, Robert F. Gagel, Steven I. Sherman, Rena Vassilopoulou-sellin, Douglas B. Evans, Jeffrey E. LeeAbstract:Background: Patients undergoing central neck surgery are at risk for hypoparathyroidism. We hypothesized that Gamma Probe identification of sestamibi-labeled parathyroid glands might help maximize parathyroid preservation. Methods: Records of 351 patients who underwent central neck surgery were reviewed. A subgroup of patients underwent sestamibi injection followed by Gamma Probe-directed parathyroid gland identification. Results: Operation was performed for malignancy in 73% of patients and represented a reoperation in 34%. Persistent hypoparathyroidism was more common in patients who underwent reoperation versus a primary operation (6.8% versus 1.7%; P 0.02). Thirteen patients underwent Gamma Probe-directed identification of sestamibi-labeled parathyroid glands; in 6 of these patients, sestamibi-labeled parathyroid glands were salvaged from the resected specimens and autografted. None of these 13 patients developed persistent hypoparathyroidism. Conclusions: Patients undergoing reoperative central neck surgery are at increased risk for postoperative hypoparathyroidism. Gamma Probe-directed salvage of sestamibi-labeled parathyroid glands may help maximize parathyroid preservation, especially in complex or reoperative central neck surgery. © 2003 Excerpta Medica, Inc. All rights reserved.
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relative contributions of technetium tc 99m sestamibi scintigraphy intraoperative Gamma Probe detection and the rapid parathyroid hormone assay to the surgical management of hyperparathyroidism
Archives of Surgery, 2000Co-Authors: Alan P B Dackiw, Herbert A. Fritsche, Ebrahim Delpassand, Robert F. Gagel, Douglas B. Evans, Jeffrey E. Lee, Jeffrey J Sussman, Pam Stanford, Ana O HoffAbstract:Hypothesis Technetium Tc 99m sestamibi scintigraphy, intraoperative Gamma Probe detection, and the rapid parathyroid hormone assay have been used to permit a directed operation in patients with hyperparathyroidism. We hypothesized that the coordinated use of these techniques might be particularly useful in patients who require a second operation for hyperparathyroidism. Design Retrospective analysis was performed to determine the specific contribution of these technologies to the surgical management of patients with hyperparathyroidism who underwent evaluation by at least 2 of these techniques between April 1996 and October 1999. Setting Patients were evaluated and treated by an endocrine tumor surgery group within a tertiary care referral center. Patients Coordinated application of 99m Tc-sestamibi scintigraphy, intraoperative Gamma Probe detection, and/or the rapid parathyroid hormone assay was performed in 32 patients. Results Twenty-eight of 32 patients had primary hyperparathyroidism, 3 had multiple endocrine neoplasia type 1, and 1 had secondary hyperparathyroidism. The surgical procedure was an initial cervical exploration in 19 and a second operative procedure in 13. Parathyroidectomy was successful in all patients. A directed anatomic operation was performed in 24 patients, including 11 patients who underwent second operative procedures and 9 patients who underwent minimally invasive procedures under local anesthesia. A directed operation was facilitated by sestamibi scan in 22 of 24 patients, intraoperative Gamma Probe detection in 5 of 23 patients, and the rapid parathyroid hormone assay in 15 of 15 patients. Conclusions Coordinated application of 99m Tc-sestamibi scintigraphy, intraoperative Gamma Probe detection, and the rapid parathyroid hormone assay allows for successful directed reoperative parathyroidectomy; a minimally invasive procedure may be performed in selected patients.
Alan P B Dackiw - One of the best experts on this subject based on the ideXlab platform.
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relative contributions of technetium tc 99m sestamibi scintigraphy intraoperative Gamma Probe detection and the rapid parathyroid hormone assay to the surgical management of hyperparathyroidism
Archives of Surgery, 2000Co-Authors: Alan P B Dackiw, Herbert A. Fritsche, Ebrahim Delpassand, Robert F. Gagel, Douglas B. Evans, Jeffrey E. Lee, Jeffrey J Sussman, Pam Stanford, Ana O HoffAbstract:Hypothesis Technetium Tc 99m sestamibi scintigraphy, intraoperative Gamma Probe detection, and the rapid parathyroid hormone assay have been used to permit a directed operation in patients with hyperparathyroidism. We hypothesized that the coordinated use of these techniques might be particularly useful in patients who require a second operation for hyperparathyroidism. Design Retrospective analysis was performed to determine the specific contribution of these technologies to the surgical management of patients with hyperparathyroidism who underwent evaluation by at least 2 of these techniques between April 1996 and October 1999. Setting Patients were evaluated and treated by an endocrine tumor surgery group within a tertiary care referral center. Patients Coordinated application of 99m Tc-sestamibi scintigraphy, intraoperative Gamma Probe detection, and/or the rapid parathyroid hormone assay was performed in 32 patients. Results Twenty-eight of 32 patients had primary hyperparathyroidism, 3 had multiple endocrine neoplasia type 1, and 1 had secondary hyperparathyroidism. The surgical procedure was an initial cervical exploration in 19 and a second operative procedure in 13. Parathyroidectomy was successful in all patients. A directed anatomic operation was performed in 24 patients, including 11 patients who underwent second operative procedures and 9 patients who underwent minimally invasive procedures under local anesthesia. A directed operation was facilitated by sestamibi scan in 22 of 24 patients, intraoperative Gamma Probe detection in 5 of 23 patients, and the rapid parathyroid hormone assay in 15 of 15 patients. Conclusions Coordinated application of 99m Tc-sestamibi scintigraphy, intraoperative Gamma Probe detection, and the rapid parathyroid hormone assay allows for successful directed reoperative parathyroidectomy; a minimally invasive procedure may be performed in selected patients.
David N Krag - One of the best experts on this subject based on the ideXlab platform.
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The Gamma-Probe-guided resection of radiolabeled primary lymph nodes.
Surgical Oncology Clinics of North America, 2018Co-Authors: James C Alex, David N KragAbstract:The histologic status of the first draining (primary) lymph node is reportedly predictive of regional micrometastases in cutaneous melanoma and carcinoma of the breast. We review our experience with Gamma-Probe localization and biopsy—an easy, accurate, and minimally invasive technique by which the radiolabeled primary lymph node is resected.
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Gamma Probe localization of cranial bone lesions.
Ophthalmic Plastic and Reconstructive Surgery, 1999Co-Authors: Gregory D. Albert, James C Alex, David N Krag, David A. WeinbergAbstract:Purpose: Staging of cancer is essential to formulate appropriate treatment plans and to help predict prognosis. A solitary region ofincreased radionuclide uptake (hot spot) on a bone scan may represent a metastasis or a masquerading lesion. Biopsy may be required to determine its histologic nature, but localization of the site may be difficult because bone scans provide poor spatial resolution. Methods: In two patients with breast carcinoma, radioactive technetium was administered intravenously and a Gamma Probe was used preoperatively and intraoperatively to identify the site of cranial bone involvement. Results: The lesions were resected; one was a benign fibro-osseous lesion and one was a metastatic breast adenocarcinoma. Conclusions: A Gamma Probe may be helpful in localizing the site of radioactive uptake identified by bone scan.
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Gamma-Probe-guided lymph node localization in malignant melanoma
Surgical Oncology-oxford, 1993Co-Authors: James C Alex, Donald L. Weaver, J.t. Fairbank, B.s. Rankin, David N KragAbstract:The initial draining lymph node (sentinel node) has been successfully localized using intraoperative vital dye mapping and reportedly is predictive of regional nodal metastases in Clinical- Stage 1 melanoma [1]. In an animal model, we previously established the technique of Gamma-Probe-guided localization of the technetium-99 sulfur colloid labelled sentinel node [2] and found its sensitivity equal to vital dye mapping. We now report our initial experience using Gamma-Probe-guided localization to identify and then surgically remove the first draining lymph node(s) in 10 malignant melanoma patients. Lymphoscintigraphy was used to confirm localization. We conclude that this technique: (a) reliably localizes the sentinel node draining the site of a primary melanoma, (b) allows the lymphatic bed to be checked intraoperatively verifying complete sentinel node biopsy, and (c) is relatively simple and can be performed under local anaesthesia.
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Gamma Probe guided localization of lymph nodes
Surgical Oncology-oxford, 1993Co-Authors: James C Alex, David N KragAbstract:Abstract The initial draining lymph node (Sentinel node) of a tumour may reflect the status of the tumours spread to the remaining lymphatic bed. The sentinel node, which has been reported to predict metastatic melanoma, has recently been localized by a new invasive technique [1]. The goal of our pre-clinical trial was to test a non-invasive technique to localize the sentinel node. Gamma-Probe guided localization was used to identify and then surgically remove the first draining lymph node(s) in 16 inguinal lymphatic basins of eight cats. This method was found to be comparable to an invasive method using a blue dye. Gamma-Probe localization has several potential advantages in that it can: (a) precisely locate on the surface of the skin the position of an underlying lymph node, (b) intraoperatively guide the surgeon to the lymph node during dissection, (c) verify that the correct node has been biopsied, (d) determine the possible presence of residual lymph nodes, (e) allow lymph nodes to be harvested through a small incision as opposed to raising a skin flap, and (f) be rapidly and easily performed.
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Gamma Probe location of 111 indium labeled b72 3 an extension of immunoscintigraphy
Journal of Surgical Oncology, 1992Co-Authors: David N Krag, Michael H Taylor, Michael K Haseman, Philip D. Schneider, Patrick V. Ford, Lloyd H. Smith, James E GoodnightAbstract:: Eight colorectal and 5 ovarian cancer patients were evaluated with preoperative immunoscintigraphy and intraoperative Gamma Probe detection of 111indium-labeled monoclonal antibody B72.3. Immunoscintigraphy detected the presence of tumor in every patient shown to have tumor at surgery. There was one false-positive scan. A total of 21 pathologically verified lesions were identified at surgery in the 11 patients with tumor. Immunoscintigraphy localized 12 (57%) and intraoperative Gamma Probe detection located 17 (81%) of the lesions. Intraoperative Probe detection located 6 of 8 lesions smaller than 1 cm and 3 lesions that were not identified on initial surgical exploration. The Gamma Probe offers information that is complementary to immunoscintigraphy in that (1) it aids the surgeon in locating intra- and extra-abdominal lesions previously identified by immunoscintigraphy, (2) it locates lesions too small to be seen by immunoscintigraphy alone, (3) it locates lesions that otherwise might be missed at surgery, and (4) it provides objective evidence for adequacy of surgical resection of cancer in the abdominal cavity.
Craig Albanese - One of the best experts on this subject based on the ideXlab platform.
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^123I MIBG Mapping with Intraoperative Gamma Probe for Recurrent Neuroblastoma
Molecular Imaging and Biology, 2008Co-Authors: Andrei Iagaru, David Peterson, Andrew Quon, Sanjeev Dutta, Claire Twist, Farhdad Daghighian, Sanjiv Sam Gambhir, Craig AlbaneseAbstract:Intraoperative Gamma Probe guidance has become widely utilized for sentinel lymph node dissection in patients with breast cancer and melanoma, using ^99mTc sulfur colloid. However, new indications are possible and need to continue to be investigated. We report the use during a wedge liver biopsy of a new hand-held Gamma Probe designed for ^123I intraoperative guidance. The patient studied is a 5-year-old boy with history of stage 4 high-risk neuroblastoma. Anatomic imaging (CT, MRI), ^99mTc bone scintigraphy and 2-deoxy-2-[ F -18]fluoro- d -glucose—positron emission tomography/computed tomography (FDG-PET/CT) were negative, but the ^123I MIBG scintigraphy suggested recurrent liver disease. A decision was made to biopsy these lesions to obtain histopathological confirmation. Intraoperative Gamma Probe mapping of the liver identified areas with signal above the background, but these were prove to be hemosiderin deposits on histo-pathology examination.
Andrei Iagaru - One of the best experts on this subject based on the ideXlab platform.
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^123I MIBG Mapping with Intraoperative Gamma Probe for Recurrent Neuroblastoma
Molecular Imaging and Biology, 2008Co-Authors: Andrei Iagaru, David Peterson, Andrew Quon, Sanjeev Dutta, Claire Twist, Farhdad Daghighian, Sanjiv Sam Gambhir, Craig AlbaneseAbstract:Intraoperative Gamma Probe guidance has become widely utilized for sentinel lymph node dissection in patients with breast cancer and melanoma, using ^99mTc sulfur colloid. However, new indications are possible and need to continue to be investigated. We report the use during a wedge liver biopsy of a new hand-held Gamma Probe designed for ^123I intraoperative guidance. The patient studied is a 5-year-old boy with history of stage 4 high-risk neuroblastoma. Anatomic imaging (CT, MRI), ^99mTc bone scintigraphy and 2-deoxy-2-[ F -18]fluoro- d -glucose—positron emission tomography/computed tomography (FDG-PET/CT) were negative, but the ^123I MIBG scintigraphy suggested recurrent liver disease. A decision was made to biopsy these lesions to obtain histopathological confirmation. Intraoperative Gamma Probe mapping of the liver identified areas with signal above the background, but these were prove to be hemosiderin deposits on histo-pathology examination.
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RAPID COMMUNICATION 123 I MIBG Mapping with Intraoperative Gamma Probe for Recurrent Neuroblastoma
2008Co-Authors: Andrei Iagaru, Andrew Quon, Sanjeev Dutta, Claire Twist, Farhdad Daghighian, Sanjiv Sam Gambhir, David A. Peterson, Craig T. AlbaneseAbstract:Intraoperative Gamma Probe guidance has become widely utilized for sentinel lymph node dissection in patients with breast cancer and melanoma, using 99m Tc sulfur colloid. However, new indications are possible and need to continue to be investigated. We report the use during a wedge liver biopsy of a new hand-held Gamma Probe designed for 123 I intraoperative guidance. The patient studied is a 5-year-old boy with history of stage 4 high-risk neuroblastoma. Anatomic imaging (CT, MRI), 99m Tc bone scintigraphy and 2-deoxy-2-[F-18]fluoro-d-glucoseVpositron emission tomography/computed tomography (FDG-PET/CT) were negative, but the 123 I MIBG scintigraphy suggested recurrent liver disease. A decision was made to biopsy these lesions to obtain histopathological confirmation. Intraoperative Gamma Probe mapping of the liver identified areas with signal above the background, but these were prove to be hemosiderin deposits on histo-pathology examination.
