An operative gamma camera for sentinel lymph node procedure in case of breast cancer

Large field of view gamma cameras are widely used to perform lymphoscintigraphy in the sentinel lymph nodes (SLN) procedure in case of breast cancer. However, they are not specified for this application and their sizes do not enable their use in the operative room to control the excision of the all SLN. We present the results obtained with a prototype of a new mini gamma camera developed especially for the operative lymphoscintigraphy of the axillary area in case of breast cancer. This prototype is composed of 10 mm thick parallel lead collimator, a 2 mm thick GSO:Ce inorganic scintillating crystal from Hitachi and a Hamamatsu H8500 flat panel multianode (64 channels) photomultiplier tube (MAPMT) equipped with a dedicated electronics. Its actual field of view is 50 × 50 mm2. The gamma interaction position in the GSO scintillating plate is obtained by calculating the center of gravity of the fired MAPMT channels. The measurements performed with this prototype demonstrate the usefulness of this mini gamma camera for the pre, per and post-operative identification of SLN’s and how its complementary role with an intraoperative handheld gamma probe enables to improve the efficiency of this practice. A 100 × 100 mm2 field of view camera designated to cover the entire axillary area is under investigation.