Multimodal imaging and detection approach to 18F-FDG-directed surgery for patients with known or suspected malignancies: a comprehensive description of the specific methodology utilized in a single-institution cumulative retrospective experience

World Journal of Surgical Oncology

Research

Charles L Hitchcock¹  Jay R Gaglani²  Douglas A Murrey²  Eamonn E Bahnson²  Andrew Z Chow²  Nathan C Hall²  Cathy M Mojzisik³  Michael V Knopp⁴  Stephen P Povoski⁵  Maureen P Kuhrt⁵  Edward W Martin⁵ 

[1] Department of Pathology, The Ohio State University Medical Center, 43210, Columbus, Ohio, USA;Department of Radiology, The Ohio State University Medical Center, 43210, Columbus, Ohio, USA;Department of Radiology, The Ohio State University Medical Center, 43210, Columbus, Ohio, USA;Veeda Oncology, 43215, Columbus, Ohio, USA;Department of Radiology, The Ohio State University Medical Center, 43210, Columbus, Ohio, USA;Wright Center of Innovation in Biomedical Imaging, The Ohio State University Medical Center, 43210, Columbus, Ohio, USA;Division of Surgical Oncology, Department of Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and Comprehensive Cancer Center, The Ohio State University Medical Center, 43210, Columbus, Ohio, USA;

关键词: Detection Approach;    Multimodal Imaging;    Preoperative Patient;    Histologic Tumor Type;    Specimen Imaging;   

DOI  :  10.1186/1477-7819-9-152

 received in 2011-07-31, accepted in 2011-11-23,  发布年份 2011

来源: Springer

【 摘 要 】

Background18F-FDG PET/CT is widely utilized in the management of cancer patients. The aim of this paper was to comprehensively describe the specific methodology utilized in our single-institution cumulative retrospective experience with a multimodal imaging and detection approach to 18F-FDG-directed surgery for known/suspected malignancies.MethodsFrom June 2005-June 2010, 145 patients were injected with 18F-FDG in anticipation of surgical exploration, biopsy, and possible resection of known/suspected malignancy. Each patient underwent one or more of the following: (1) same-day preoperative patient diagnostic PET/CT imaging, (2) intraoperative gamma probe assessment, (3) clinical PET/CT specimen scanning of whole surgically resected specimens (WSRS), research designated tissues (RDT), and/or sectioned research designated tissues (SRDT), (4) micro PET/CT specimen scanning of WSRS, RDT, and/or SRDT, (5) total radioactivity counting of each SRDT piece by an automatic gamma well counter, and (6) same-day postoperative patient diagnostic PET/CT imaging.ResultsSame-day 18F-FDG injection dose was 15.1 (± 3.5, 4.6-26.1) mCi. Fifty-five same-day preoperative patient diagnostic PET/CT scans were performed. One hundred forty-two patients were taken to surgery. Three of the same-day preoperative patient diagnostic PET/CT scans led to the cancellation of the anticipated surgical procedure. One hundred forty-one cases utilized intraoperative gamma probe assessment. Sixty-two same-day postoperative patient diagnostic PET/CT scans were performed. WSRS, RDT, and SRDT were scanned by clinical PET/CT imaging and micro PET/CT imaging in 109 and 32 cases, 33 and 22 cases, and 49 and 26 cases, respectively. Time from 18F-FDG injection to same-day preoperative patient diagnostic PET/CT scan, intraoperative gamma probe assessment, and same-day postoperative patient diagnostic PET/CT scan were 73 (± 9, 53-114), 286 (± 93, 176-532), and 516 (± 134, 178-853) minutes, respectively. Time from 18F-FDG injection to scanning of WSRS, RDT, and SRDT by clinical PET/CT imaging and micro PET/CT imaging were 389 (± 148, 86-741) and 458 (± 97, 272-656) minutes, 619 (± 119, 253-846) and 661 (± 117, 433-835) minutes, and 674 (± 186, 299-1068) and 752 (± 127, 499-976) minutes, respectively.ConclusionsOur multimodal imaging and detection approach to 18F-FDG-directed surgery for known/suspected malignancies is technically and logistically feasible and may allow for real-time intraoperative staging, surgical planning and execution, and determination of completeness of surgical resection.

【 授权许可】

CC BY   
© Povoski et al; licensee BioMed Central Ltd. 2011