Multimodal imaging and detection approach to F-18-FDG-directed surgery for patients with known or suspected malignancies: a comprehensive description of the specific methodology utilized in a single-institution cumulative retrospective experience

作者：Povoski Stephen P^*; Hall Nathan C; Murrey Douglas A Jr; Chow Andrew Z; Gaglani Jay R; Bahnson Eamonn E; Mojzisik Cathy M; Kuhrt Maureen P; Hitchcock Charles L; Knopp Michael V; Martin Edward W Jr

来源：World Journal of Surgical Oncology, 2011, 9: 152.

DOI：10.1186/1477-7819-9-152

Background: F-18-FDG PET/CT is widely utilized in the management of cancer patients. The aim of this paper was to comprehensively describe the specific methodology utilized in our single-institution cumulative retrospective experience with a multimodal imaging and detection approach to F-18-FDG-directed surgery for known/suspected malignancies.
Methods: From June 2005-June 2010, 145 patients were injected with F-18-FDG in anticipation of surgical exploration, biopsy, and possible resection of known/suspected malignancy. Each patient underwent one or more of the following: (1) same-day preoperative patient diagnostic PET/CT imaging, (2) intraoperative gamma probe assessment, (3) clinical PET/CT specimen scanning of whole surgically resected specimens (WSRS), research designated tissues (RDT), and/or sectioned research designated tissues (SRDT), (4) micro PET/CT specimen scanning of WSRS, RDT, and/or SRDT, (5) total radioactivity counting of each SRDT piece by an automatic gamma well counter, and (6) same-day postoperative patient diagnostic PET/CT imaging.
Results: Same-day F-18-FDG injection dose was 15.1 (+/- 3.5, 4.6-26.1) mCi. Fifty-five same-day preoperative patient diagnostic PET/CT scans were performed. One hundred forty-two patients were taken to surgery. Three of the same-day preoperative patient diagnostic PET/CT scans led to the cancellation of the anticipated surgical procedure. One hundred forty-one cases utilized intraoperative gamma probe assessment. Sixty-two same-day postoperative patient diagnostic PET/CT scans were performed. WSRS, RDT, and SRDT were scanned by clinical PET/CT imaging and micro PET/CT imaging in 109 and 32 cases, 33 and 22 cases, and 49 and 26 cases, respectively. Time from F-18-FDG injection to same-day preoperative patient diagnostic PET/CT scan, intraoperative gamma probe assessment, and same-day postoperative patient diagnostic PET/CT scan were 73 (+/- 9, 53-114), 286 (+/- 93, 176-532), and 516 (+/- 134, 178-853) minutes, respectively. Time from F-18-FDG injection to scanning of WSRS, RDT, and SRDT by clinical PET/CT imaging and micro PET/CT imaging were 389 (+/- 148, 86-741) and 458 (+/- 97, 272656) minutes, 619 (+/- 119, 253-846) and 661 (+/- 117, 433-835) minutes, and 674 (+/- 186, 299-1068) and 752 (+/- 127, 499-976) minutes, respectively.
Conclusions: Our multimodal imaging and detection approach to F-18-FDG-directed surgery for known/suspected malignancies is technically and logistically feasible and may allow for real-time intraoperative staging, surgical planning and execution, and determination of completeness of surgical resection.

• 出版日期2011-11-23