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Revista Española de Medicina Nuclear e Imagen Molecular (English Edition) Continuous innovation in precision radio-guided surgery
Journal Information
Vol. 43. Issue 1.
Pages 39-54 (January - February 2024)
Visits
47
Vol. 43. Issue 1.
Pages 39-54 (January - February 2024)
Original Article
Continuous innovation in precision radio-guided surgery
Innovación continuada en cirugía radioguiada de precisión
Visits
47
Sergi Vidal-Sicarta,b,
Corresponding author
Svidal@cllinic.cat

Corresponding author.
, Elena Goñic, Isaac Cebrecosd, Mª Eugenia Riojae, Andrés Perissinottia,b,f, Catalina Sampolg, Oscar Vidalb,h,i, David Saavedra-Pérezh, Ada Ferrerj, Carles Martíj, José Ferrer Rebolledak, Mª José García Vellosol, Jhon Orozco-Cortésm, Berta Díaz-Feijóob,d,i, Aida Niñerola-Baizána,b,f,n, Renato Alfredo Valdés Olmoso
a Servicio de Medicina Nuclear, Hospital Clínic Barcelona, Barcelona, Spain
b Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
c Servicio de Medicina Nuclear, Hospital Universitario de Navarra, Pamplona, Spain
d Instituto Clínic de Ginecología, Obstetricia y Neonatología (ICGON), Hospital Clínic Barcelona, Barcelona, Spain
e Medicina Nuclear, MD Anderson Cancer Center, Madrid, Spain
f Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), ISCIII, Madrid, Spain
g Servicio de Medicina Nuclear, Hospital Universitario Son Espases, Palma de Mallorca, Spain
h Cirugía General y Digestiva, ICMDiM, Hospital Clínic de Barcelona, Barcelona, Spain
i Departamento de Cirugía, Universitat de Barcelona, Barcelona, Spain
j Servicio de Cirugía Maxilofacial, Hospital Clínic Barcelona, Barcelona, Spain
k Servicio Medicina Nuclear Ascires, Hospital General Universitario de Valencia, Valencia, Spain
l Servicio Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, Spain
m Servicio de Medicina Nuclear, Hospital Clínico Universitario de Valencia, Barcelona, Spain
n Departamento de Biomedicina, Facultad de Medicina, Universitat de Barcelona, Barcelona, Spain
o Department of Radiology, Section of Nuclear Medicine & Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
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Table 1. Inconveniences of each of the localizer devices.
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Abstract

Since its origins, nuclear medicine has faced technological changes that led to modifying operating modes and adapting protocols. In the field of radioguided surgery, the incorporation of preoperative scintigraphic imaging and intraoperative detection with the gamma probe provided a definitive boost to sentinel lymph node biopsy to become a standard procedure for melanoma and breast cancer.

The various technological innovations and consequent adaptation of protocols come together in the coexistence of the disruptive and the gradual. As obvious examples we have the introduction of SPECT/CT in the preoperative field and Drop-in probes in the intraoperative field. Other innovative aspects with possible application in radio-guided surgery are based on the application of artificial intelligence, navigation and telecare.

Keywords:
Radio-guided surgery
Sentinel lymph node
Hybrid equipment
Fluorescence
Intraoperative imaging
Artificial intelligence
Virtual reality
Resumen

La medicina nuclear se ha enfrentado desde sus inicios con cambios tecnológicos que llevaron a modificar modos operativos y adecuar protocolos. En el campo de la cirugía radioguiada la incorporación de la imagen gammagráfica preoperatoria y la detección intraoperatoria con la sonda gamma proporcionó un impulso definitivo a la biopsia del ganglio centinela para convertirse en procedimiento en el estándar de aplicación en el melanoma y el cáncer de mama.

Las diversas innovaciones tecnológicas y adaptación consiguiente de protocolos confluyen en la coexistencia de lo disruptivo y lo gradual. Como ejemplos evidentes tenemos la introducción de la SPECT/TC en el campo preoperatorio y las sondas Drop-in en el intraoperatorio. Otros aspectos innovadores con posible aplicación en la cirugía radioguiada se basan en la aplicación de inteligencia artificial, navegación y teleasistencia.

Palabras clave:
Cirugía radioguiada
Ganglio centinela
Equipos híbridos
Fluorescencia
Imagen intraoperatoria
Inteligencia artificial
Realidad virtual

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