A Portable γ-Camera for Intraoperative Detection of Sentinel Nodes in the Head and Neck Region

We introduced and evaluated a portable gamma-camera for intraoperative visualization of sentinel nodes in the head and neck region. Methods: Planar lymphoscintigraphy and SPECT/CT were performed after peritumoral injection of Tc-99m-nanocolloid in 25 patients (head and neck melanoma or oral cavity carcinoma). Sentinel nodes were localized intraoperatively with a portable g-camera and a hand-held g-probe. The portable g-camera was used to determine the distribution of remaining radioactivity after excision of the sentinel nodes. Results: The portable g-camera visualized all 70 preoperatively identified sentinel nodes. Sentinel nodes at difficult sites could be localized more efficiently, and in 6 patients, 9 additional nodes (1 tumor-positive) were identified with the portable gamma-camera after excision. Conclusion: Intraoperative identification of sentinel nodes in the head and neck region with a portable gamma-camera is feasible and might lead to detection of more sentinel nodes.