ProjectGammaProbe

Chair for Computer Aided Medical Procedures & Augmented Reality
Lehrstuhl für Informatikanwendungen in der Medizin & Augmented Reality

Freehand SPECT for Sentinel Lymph Node Localization

Freehand SPECT for Sentinel Lymph Node Localization

In medical collaboration with:
Prof. Dr. Markus Schwaiger, Chefarzt, Nuklearmedicine, Klinikum rechts der Isar, TUM, Munich, Germany
PD Dr. Andreas Buck, Oberarzt, Nuklearmedicine, Klinikum rechts der Isar, TUM, Munich, Germany
Dr. Ken Herrmann, Assistenzarzt, Nuklearmedicine, Klinikum rechts der Isar, TUM, Munich, Germany
Prof. Dr. Marion Kiechle, Chefarzt, Gynaecology, Klinikum rechts der Isar, TUM, Munich, Germany
Dr. Stefan Paepke, Leitender Oberarzt, Gynaecology, Klinikum rechts der Isar, TUM, Munich, Germany
Dr. Andreas Schnelzer, Oberarzt, Gynaecology, Klinikum rechts der Isar, TUM, Munich, Germany
Dr. Alexandra Ehlerding, Assistenzarzt, Gynaecology, Klinikum rechts der Isar, TUM, Munich, Germany
Prof. Dr. Helmuth Friess, Chefarzt, Surgery, Klinikum rechts der Isar, TUM, Munich, Germany
Dr. Marc Martignoni, Oberarzt, Surgery, Klinikum rechts der Isar, TUM, Munich, Germany
Dr. Jakob Saeckl, Assistenzarzt, Surgery, Klinikum rechts der Isar, TUM, Munich, Germany
Prof. Dr. Stefano Fanti, Chefarzt, Nuklearmedicine, Asienda Ospidaliera S.Orsola-Malpighi, University of Bologna, Bologna, Italy
Dr. Ivan Santi, Assistenzarzt, Nuklearmedicine, Asienda Ospidaliera S.Orsola-Malpighi, University of Bologna, Bologna, Italy
Dr. Lorenzo Fantini, Assistenzarzt, Nuklearmedicine, Asienda Ospidaliera S.Orsola-Malpighi, University of Bologna, Bologna, Italy

In academic collaboration with:
Dr. Mario Marengo, Head Physicist, Nuklearmedicine, Asienda Ospidaliera S.Orsola-Malpighi, University of Bologna, Bologna, Italy

Scientific Director: Nassir Navab, Sibylle Ziegler

Contact Person(s): Thomas Wendler

In industrial collaboration with:
Dr. Joerg Traub, Managing Director, SurgicEye GmbH?, Munich, Germany

Keywords: Medical Imaging, Molecular Imaging, Computer-Aided Surgery, Medical Augmented Reality

Abstract

Nuclear medicine imaging modalities assist commonly in surgical guidance given their functional nature. However, when used in the operating room they present limitations. Pre-operative tomographic 3D imaging can only serve as a vague guidance intra-operatively, due to movement, deformation and changes in anatomy since the time of imaging, while standard intra-operative nuclear measurements are limited to 1D or (in some cases) 2D images with no depth information. To resolve this problem we propose the synchronized acquisition of position, orientation and readings of gamma probes intra-operatively to reconstruct a 3D activity volume. In contrast to conventional emission tomography, here, in a first proof-of-concept, the reconstruction succeeds without requiring symmetry in the positions and angles of acquisition, which allows greater flexibility and thus opens doors towards 3D intra-operative nuclear imaging.

Publications

2010
A. Buck, A. Schnelzer, T. Wendler, K. Herrmann, T. Lasser, J. Traub, O. Kutter, T. Schuster, A. Ehlerding, K. Scheidhauer, M. Kiechle, N. Navab, S. Ziegler, M. Schwaiger
First demonstration of 3D lymphatic mapping in breast cancer using freehand SPECT
Proceedings of DGN Nuklearmedizin 2010, Leipzig, Germany, April 2010 (bib)
K. Herrmann, A. Schnelzer, T. Wendler, M. Hoyer, D. Weisgerber, T. Lasser, S. Paepke, M. Martignoni, M. Kiechle, N. Navab, S. Ziegler, M. Schwaiger
Evaluation of feasibility of freehand SPECT in the operating room
Proceedings of DGN Nuklearmedizin 2010, Leipzig, Germany, April 2010 (bib)
2009
T. Wendler, K. Herrmann, A. Schnelzer, T. Lasser, J. Traub, O. Kutter, T. Schuster, M. Kiechle, M. Schwaiger, N. Navab, S. Ziegler, A. Buck
Clinical introduction of freehand SPECT for image-guided sentinel lymph node biopsy
Proceedings of Annual Congress of the European Association of of Nuclear Medicine (EANM 2009), Barcelona, Spain, October 2009 (bib)
T. Wendler, X. Feng, K. Herrmann, T. Lasser, J. Traub, S. Ziegler, N. Navab, A. Buck
2D/3D registration of freehand SPECT and planar scintigraphy for clinical evaluation of 3D thyroid scintigraphy
Proceedings of Annual Congress of the European Association of of Nuclear Medicine (EANM 2009), Barcelona, Spain, October 2009 (bib)
T. Wendler, K. Herrmann, T. Lasser, J. Traub, M. Schwaiger, N. Navab, S. Ziegler, A. Buck
First experience with freehand SPECT for lymphatic mapping in melanoma in upper body
Proceedings of Annual Congress of the European Association of of Nuclear Medicine (EANM 2009), Barcelona, Spain, October 2009 (bib)
T. Wendler, T. Lasser, J. Traub, S. Ziegler, N. Navab
Freehand SPECT / ultrasound fusion for hybrid image-guided resection
Proceedings of Annual Congress of the European Association of of Nuclear Medicine (EANM 2009), Barcelona, Spain, October 2009 (bib)
T. Lasser, A. Duliu, T. Wendler, S. Ziegler, N. Navab
Interactive Reconstruction for Freehand SPECT: An Approach to Acquisition Guidance?
Proceedings of Annual Congress of the European Association of of Nuclear Medicine (EANM 2009), Barcelona, Spain, October 2009 (bib)
T. Wendler, K. Herrmann, T. Lasser, J. Traub, M. Schwaiger, S. Ziegler, N. Navab, A. Buck
Freehand SPECT: first in-vivo evaluation and comparison to conventional lymphatic mapping
Proceedings of Annual Meeting of Society of Nuclear Medicine (SNM 2009), Toronto, USA, June 2009 (bib)
T. Wendler, X. Feng, T. Lasser, K. Herrmann, J. Traub, K. Scheidhauer, S. Ziegler, D. Lenhart, J. Grahneis, M. Schwaiger, N. Navab, A. Buck
Freehand SPECT for 3D thyroid scintigraphy: first patient report
Proceedings of DGN Nuklearmedizin 2009, Leipzig, Germany, April 2009 (bib)
K. Herrmann, T. Wendler, M. Chen, A. Bartel, T. Lasser, K. Scheidhauer, J. Traub, T. Schuster, S. Ziegler, M. Schwaiger, A. Buck, N. Navab
Freehand SPECT: first in-vivo use for lymphatic mapping and comparison to conventional imaging
Proceedings of DGN Nuklearmedizin 2009, Leipzig, Germany, April 2009 (bib)
2008
T. Wendler, T. Lasser, A. Buck, C. Özgür, M. Schwaiger, S. Ziegler, N. Navab
First in Vivo Use of a Fused Gamma Ultrasound System
Proceedings of RSNA 2008, Chicago, USA, December 2008 (bib)
T. Wendler, T. Lasser, S. Ziegler, N. Navab
Towards Confident 3D Tomographic Reconstruction for Asymmetric, Sparse Detector Geometries
Proceedings of IEEE Medical Imaging Conference (IEEE MIC 2008), Dresden, Germany, October 2008 (bib)
T. Lasser, T. Wendler, S. Ziegler, N. Navab
Towards Reproducibility of Freehand 3D Tomographic Nuclear Imaging
Proceedings of IEEE Medical Imaging Conference (IEEE MIC 2008), Dresden, Germany, October 2008 (bib)
T. Lasser, T. Wendler, J. Traub, S. Ziegler, N. Navab
Definition of optimal collimator geometries for 3D tomographic thyroid scintigraphy using navigated gamma probes
Proceedings of Annual Congress of the European Association of Nuclear Medicine (EANM 2008), Munich, Germany, October 2008 (bib)
T. Wendler, T. Lasser, A. Buck, J. Traub, M. Schwaiger, S. Ziegler, N. Navab
First case report of 3D tomographic thyroid scintigraphy with tracked gamma probes
Proceedings of Annual Congress of the European Association of Nuclear Medicine (EANM 2008), Munich, Germany, October 2008, Eur J Nuc Med Mol Imaging, vol. 35 (Suppl. 2), S129 (bib)
T. Wendler, J. Traub, T. Lasser, M. Feuerstein, J. Vogel, S. Ziegler, N. Navab
Combined ultrasound and gamma probe imaging for examination of thyroid nodules
Proceedings of Annual Meeting of Society of Nuclear Medicine (SNM 2008), New Orleans, USA, June 2008 (bib)
T. Wendler, A. Hartl, T. Lasser, J. Traub, S. Ziegler, N. Navab
3D Intra-operative nuclear imaging for SLNB in neck
Proceedings of Annual Meeting of Society of Nuclear Medicine (SNM 2008), New Orleans, USA, June 2008 (bib)
N. Navab, J. Traub, A. Buck, S. Ziegler, T. Wendler
Navigated nuclear probes for intra-operative functional imaging
Proceedings of 5th IEEE International Symposium on Biomedical Imaging (ISBI 2008), Paris, France, May 14 - 17 2008, pp. 1395-1398 (bib)
2007
T. Wendler, M. Feuerstein, J. Traub, T. Lasser, J. Vogel, F. Daghighian, S. Ziegler, N. Navab
Real-time fusion of ultrasound and gamma probe for navigated localization of liver metastases
Proceedings of Medical Image Computing and Computer-Assisted Intervention (MICCAI 2007), Brisbane, Australia, October 29 - November 2007, LNCS 4792 (2), pp. 909-917 (bib)
T. Wendler, A. Hartl, T. Lasser, J. Traub, F. Daghighian, S. Ziegler, N. Navab
Towards intra-operative 3D nuclear imaging: reconstruction of 3D radioactive distributions using tracked gamma probes
Proceedings of Medical Image Computing and Computer-Assisted Intervention (MICCAI 2007), Brisbane, Australia, October 29 - November 2 2007, LCNS 4792 (2), pp. 252-260 (bib)
T. Wendler, J. Traub, A. Hartl, T. Lasser, M. Burian, A. Buck, F. Daghighian, M. Schwaiger, S. Ziegler, N. Navab
Adding navigation to radio-guided surgery: new possibilities, new problems, new solutions
Proceedings of Russian Bavarian Conference on Biomedical Engineering (RBC Biomed 2007), Erlangen, Germany, July 2-3, 2007, pp. 96-100 (bib)
T. Wendler, A. Hartl, J. Traub, S. Ziegler, N. Navab
Intraoperative nuclear imaging using navigated gamma-probes for tumor localization
Proceedings of Annual Meeting of Society of Nuclear Medicine (SNM 2007), Washington D.C., USA, June 2007 (bib)

Clinical Relevance

This project aims currently at applications in breast cancer and melanoma and in particular as assistance in sentinel lymph node biopsy (SLNB). The incidence of these cancer types in 2004 was 124 and 19,6 per 100.000 in the US. The mortality is 24 and 2,6 respectively. SLNB using lymphatic mapping and gamma-probes is part of current state-of-art staging modality in both this cancer types for tumors of grade T2 and T3, but also TX (app. half of the cases). A precise localization of these nodes is not necessary easy in regions with many nodes. The biopsy of a wrong node may imply a wrong prognosis and thus can play a fundamental role in the treatment. In breast the rate of success in localization is in average 89% but varies from 41% to 100%. This is not that dramatic in melanoma, however represents still a relevant problem when aiming at a conservative procedure. The introduced system allows a secure localization without changing the workflow and can be a great assistance and a clear improvement in effectiveness of the treatment.

Team

Contact Person(s)

Thomas Wendler
M.Sc. Thomas Wendler

Working Group

Andreas Buck
Prof. Dr. Andreas Buck
Asli Okur
Asli Okur
MeiChuan Chen
M.Sc. MeiChuan Chen
Nassir Navab
Prof. Dr. Nassir Navab
Sibylle Ziegler
Prof. Dr. Sibylle Ziegler
Tobias Lasser
Dipl.-Inf. Univ. Tobias Lasser

Alumni

Abtin Rasoulian
Abtin Rasoulian
Alexander Hartl
Alexander Hartl
Berenika Zaraska
Berenika Zaraska
Irene Faure de Pebeyre
Irene Faure de Pebeyre
Joerg Traub
Dr. Joerg Traub
Xinxing Feng
Xinxing Feng

Location



Klinikum rechts der Isar
der Technischen Universitüt München
Ismaninger Str. 22
81675 München

IFL Lab - Room: 01.3a-c
Tel.: +49 89 4140-6457
Fax: +49 89 4140-6458
Visit our lab at Klinikum rechts der Isar.



internal project page

Please contact Thomas Wendler for available student projects within this research project.

Edit | Attach | Refresh | Diffs | More | Revision r1.8 - 13 Sep 2007 - 21:24 - ThomasWendler

Lehrstuhl für Computer Aided Medical Procedures & Augmented Reality    rss.gif