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Miniature Gamma Camera for Breast CA Goes on Clinical Trials

Centre National de la Recherche Scientifique is reporting that French scientists designed and are now clinically testing a miniature POCI (Perioperative Compact Imager) gamma camera, that can be used for radio-guided operative cancer surgery of the breast:

Dedicated to the surgical treatment of cancer, this new medical imaging device can target tumor lesions which have previously been radioactively labeled. Arising from an initial collaboration between physicists at IN2P3-CNRS, physicians at Hopital Tenon in Paris and methodologists from Paris Public Hospitals (AP-HP), this gamma camera is currently being assessed in the operating room on 200 women with breast cancer. This study, which has already generated some more than encouraging results, confirms the value of peroperative [sic] imaging techniques.

In the surgical treatment of cancer, probes acting as radioactivity counters have been introduced into the operating room to provide real-time guidance to surgeons during the ablation of previously radio-labeled tumors. This radio guidance technique enables access to the precise location of tumor tissues, and their complete ablation. It was to enhance this technique that the "Imagerie et Modélisation en Cancerologie" team at the IMNC undertook to develop a new generation of miniaturized gamma cameras to assist in the surgical treatment of cancer, called POCI. This is a particularly novel application of the recently developed instruments used in fundamental physics. With a field of view of 13 cm2 and reduced dimensions(5), this imaging device has been designed so that it can easily be positioned on the surgical wound in order to locate radio-labeled tumor lesions during the surgical procedure.

The POCI imaging device is currently being assessed in the context of a "sentinel lymph node" protocol in breast cancers. In practice, the cancer is detected by injecting a radioactive solution around the tumor. Lymphoscintigraphy can then count the lymph nodes and situate them precisely. Finally, a biopsy is usually performed in the operating room using the radioactive counter probe, which allows the surgeon to check the position of the "sentinel lymph node" prior to making an incision, in order to identify it in the surgical wound and then, after ablation, to confirm the absence of any residual radioactivity.


Clinical evaluation of the POCI camera, which for the first time is bringing together researchers from IN2P3-CNRS and AP-HP, is based on a double study: firstly, to prove its equivalence compared with standard gamma cameras, and secondly to confirm its value in the operating room regarding the identification of "sentinel lymph nodes" which are not detected by standard probes. Initiated in January 2006 with the agreement of the Ethics Committee (Comité consultatif de protection des personnes dans la recherche biomédicale, CCPPRB) and the French Agency for the Safety of Healthcare Products (Agence francaise de sécurité sanitaire des produits de santé, AFSSAPS), this clinical trial includes 200 female patients. After the examination of some 100 patients using the POCI camera, in both the Nuclear Medicine Department and the operating room, the initial results are extremely encouraging.

http://www2.cnrs.fr/en/913.htm

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