Use of intraoperative nuclear imaging leads to decreased anesthesia time and real-time confirmation of lesion removal

Joseph C Fusco; Brittani K N Seynnaeve; Alexander J Davit 3rd; Michael R Czachowski; Judith M Joyce; Barbara A Gaines; Marcus M Malek

doi:10.1016/j.jpedsurg.2017.10.019

Use of intraoperative nuclear imaging leads to decreased anesthesia time and real-time confirmation of lesion removal

J Pediatr Surg. 2017 Oct 9:S0022-3468(17)30641-3. doi: 10.1016/j.jpedsurg.2017.10.019. Online ahead of print.

Authors

Joseph C Fusco¹, Brittani K N Seynnaeve², Alexander J Davit 3rd³, Michael R Czachowski⁴, Judith M Joyce⁵, Barbara A Gaines¹, Marcus M Malek⁶

Affiliations

¹ Division of Pediatric General and Thoracic Surgery, Children's Hospital of Pittsburgh of UPMC, Department of Surgery, University of Pittsburgh School of Medicine.
² Department of Pediatric Hematology and Oncology, Children's Hospital of Pittsburgh of UPMC.
³ Division of Pediatric Plastic Surgery, Children's Hospital of Pittsburgh of UPMC.
⁴ Department of Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC.
⁵ Department of Radiology, University of Pittsburgh Medical Center Presbyterian.
⁶ Division of Pediatric General and Thoracic Surgery, Children's Hospital of Pittsburgh of UPMC, Department of Surgery, University of Pittsburgh School of Medicine. Electronic address: marcus.malek@chp.edu.

PMID: 29106918
DOI: 10.1016/j.jpedsurg.2017.10.019

Abstract

Background: Lymphatic mapping to guide sentinel lymph node biopsy (SLNB) typically requires lymphoscintigraphy prior to surgery. In young pediatric patients, this process often requires intubation in the nuclear medicine suite followed by transport to the operating room (OR).

Methods: We reviewed 14 pediatric cases in which a portable nuclear imaging camera was utilized to perform the entirety of the SLNB in the OR.

Results and conclusion: This method, utilizing intraoperative nuclear imaging, helped to confirm removal of the sentinel lymph node in real time, decreased anesthesia time, and avoided transport of a sedated or intubated child.

Level of evidence: III.

Keywords: Intraoperative nuclear imaging; Sentinel lymph node biopsy; Sentinel lymph node mapping.