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Simultaneous Detection of Breast Tumor Resection Margins and Radioguided Sentinel Node Biopsy Using an Intraoperative Electronically Collimated Probe With Variable Energy Window

A Case Report

Manca, Gianpiero, MD, PhD*; Biggi, Elisa, MD*; Lorenzoni, Alice, MD*; Boni, Giuseppe, MD*; Roncella, Manuela, MD; Ghilli, Matteo, MD; Volterrani, Duccio, MD*; Mariani, Giuliano, MD*

doi: 10.1097/RLU.0b013e31821c9a4c
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Breast-conserving surgery with intraoperative assessment of lesion margins and sentinel lymph node biopsy has become the preferred method of treatment for selected patients with early infiltrating breast cancer. A high-energy gamma probe, designed according to a novel concept of electronic collimation and variable energy window, was used in a patient with nonpalpable infiltrating breast cancer to perform simultaneous intraoperative identification of lesion margins (based on the detection of the high-energy gamma rays originated from annihilation following preoperative administration of F-18 FDG) and radioguided sentinel node biopsy (based on the single-photon agent Tc-99m-nanocolloid used for lymphoscintigraphy).

From the *Regional Center of Nuclear Medicine, University of Pisa Medical School, Pisa, Italy; and †Breast Unit, University Hospital of Pisa, Department of Oncology Transplants and Advanced Technologies in Medicine, University of Pisa, Italy.

Received for publication February 8, 2011; revision accepted March 3, 2010.

Conflicts of interest and sources of funding: none declared.

Reprints: Gianpiero Manca, MD, PhD, Regional Center of Nuclear Medicine, University Hospital of Pisa, Via Roma 67, I-56100 Pisa, Italy. E-mail:

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.