Quantitative analysis of sentinel lymph node detection using a novel small field of view hybrid gamma camera (HGC)

Abstract

Introduction The Hybrid Gamma Camera (HGC) is being developed to enhance the localisation of radiopharmaceutical uptake in targeted tissues during surgical procedures such as sentinel lymph node (SLN) biopsy. Purpose To assess the capability of the HGC, a lymph-node-contrast (LNC) phantom was constructed for an evaluative study simulating medical scenarios of varying radioactivity concentration and SLN size. Materials and methods The phantom was constructed using two methyl methacrylate PMMA plates (8 mm thick). The SLNs were simulated by drilling circular wells of diameters ranging between 10 mm and 2.5 mm (16 wells in total) in one plate. These simulated SLNs were placed underneath scattering material with thicknesses ranging between 5 mm and 40 mm. The second plate contains four rectangular wells to simulate background activity uptake surrounding the SLNs. The activity used ranged between 4 MBq and 0.025 MBq for the SLNs. The background activity was 1/10 of the SLNs activity. The collimator to source distance was 120 mm. Results Signal to Noise Ratio (SNR) analysis and spatial resolution measurements of the simulated SLN were used to compare the imaging sets over acquisition times ranging between 60s and 240s. The HGC successfully detected 87.5% to 100% of the SLNs through 20mm of scattering material, and it could detect 75% to 93.75% of the SLNs through 40mm of scattering material. Measurement of Full-Width-at-Half-Maximum (FWHM) for the detected SLNs ranged between 9.5 mm and 12 mm. Conclusion The HGC is capable of detecting low activity uptake in small SLNs indicating its usefulness as an intraoperative imaging system during surgical SLN procedures. Disclosure MSA, SLB, LKJ, BSB, WRM, NSD and AHN have no conflicts of interest to declare. Both JEL and ACP have interests in a Universities of Leicester and Nottingham spin out company called Gamma Technologies.