Monte Carlo-based optimization of a gamma probe system for sentinel lymph node mapping

Document Type : Original Article

Authors

1 Faculty of Nuclear Engineering and Physics, Amirkabir University of Technology, Tehran, Iran

2 Research Centre for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA

4 Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Iran

Abstract

Introduction: Sentinel lymph node biopsy (SLNB) is a standard surgical technique to identify sentinel lymph node (SLN) for the staging of early breast cancer. Nowadays, two methods are used for the identification of SLN: blue dye method aiding visually and radioactive dye using gamma detector. A wide range of gamma probe systems with different design and performance are used in intra-operative surgery. The performance of the probes is evaluated by some parameters such as sensitivity, spatial resolution, angular resolution, and shielding efficiency.
Methods: In this study, we simulated a gamma probe system, SURGEOGUIDE II based on CsI(Tl) scintillator, a silicon photomultiplier (SiPM), and a tungsten collimator, using the MCNP4C Monte Carlo (MC) method and comparing with experimental measurement. Finally we modeled a series of probe with various crystal material, crystal length, and collimator hole length to evaluate the sensitivity and the spatial resolution in order to propose the optimal configuration.
Results:The sensitivity of the system was measured as 2040 cps/MBq in 30 mm distance from the source. The spatial resolution and angular resolution were 43 mm and  at the same distance, respectively. Sensitivity at 30 mm distance from the probe head was the highest for BGO crystal and was the lowest for NaI crystals. The sensitivity and spatial resolution have also been changed by increasing the length of the crystal to a certain amount and then remained constant.
Conclusion: The results showed that the best choice for crystal was CdTe and CsI and the best length for CsI crystal in this type of the systems was 10 mm long. Also, based on the specific application, special probe should be designed taking the length of the collimator hole into consideration.

Keywords

Main Subjects


  1. Osako T, Iwase T, Kimura K, Yamashita K, Horii R, Yanagisawa A, Akiyama F. Intraoperative molecular assay for sentinel lymph node metastases in early stage breast cancer: a comparative analysis between one-step nucleic acid amplification whole node assay and routine frozen section histology. Cancer. 2011 Oct 1;117(19):4365-74.
  2. Cheng G, Kurita S, Torigian DA, Alavi A. Current status of sentinel lymph-node biopsy in patients with breast cancer. Eur J Nucl Med Mol Imaging. 2011 Mar;38(3):562-75.
  3. Gipponi M, Bassetti C, Canavese G, Catturich A, Di Somma C, Vecchio C, Nicolò G, Schenone F, Tomei D, Cafiero F. Sentinel lymph node as a new marker for therapeutic planning in breast cancer patients. J Surg Oncol. 2004 Mar;85(3):102-11.
  4. Kootstra JJ, Dijkstra PU, Rietman H, de Vries J, Baas P, Geertzen JH, Hoekstra HJ, Hoekstra-Weebers JE. A longitudinal study of shoulder and arm morbidity in breast cancer survivors 7 years after sentinel lymph node biopsy or axillary lymph node dissection. Breast Cancer Res Treat. 2013 May;139(1):125-34.
  5. Ahmed M, Purushotham AD, Douek M. Novel techniques for sentinel lymph node biopsy in breast cancer: a systematic review. Lancet Oncol. 2014 Jul;15(8):e351-62.
  6. Chen SL, Iddings DM, Scheri RP, Bilchik AJ. Lymphatic mapping and sentinel node analysis: current concepts and applications. CA Cancer J Clin. 2006 Sep-Oct;56(5):292-309; quiz 316-7.
  7. Gould EA, Winship T, Philbin PH, Kerr HH. Observations on a "sentinel node" in cancer of the parotid. Cancer. 1960 Jan-Feb;13:77-8.
  8. Tanis PJ, Nieweg OE, Valdés Olmos RA, Th Rutgers EJ, Kroon BB. History of sentinel node and validation of the technique. Breast Cancer Res. 2001;3(2):109-12.
  9. Myers WG, Vanderleeden JC. Radioiodine-125. J Nucl Med. 1960 Jul;1:149-64.
  10. Cengić T, Corluka S, Petrović T, Baranović S, Kovacić K, Kolundzić R. Intraoperative gamma hand-held probe navigation in resection of osteoid osteoma tumor--report of two cases. Acta Clin Croat. 2013 Jun;52(2):261-5.
  11. Wydra D, Matuszewski R, Romanowicz G, Bandurski T. Evaluation of surgical gamma probes for sentinel node localization in cervical and vulvar cancer. Nucl Med Rev Cent East Eur. 2005;8(2):105-10.
  12. Rogers DW. Fifty years of Monte Carlo simulations for medical physics. Phys Med Biol. 2006 Jul 7;51(13):R287-301.
  13. Buvat I, Castiglioni I. Monte Carlo simulations in SPET and PET. Q J Nucl Med. 2002 Mar;46(1):48-61.
  14. De Vries DJ, Moore SC, Zimmerman RE, Mueller SP, Friedland B, Lanza RC. Development and validation of a Monte Carlo simulation of photon transport in an Anger camera. IEEE Trans Med Imaging. 1990;9(4):430-8.
  15. Yanch JC, Dobrzeniecki AB. Monte Carlo simulation in SPECT:complete 3D modeling of source, collimator and tomographicdata acquisition. IEEE Trans Nucl Sci. 1993;198-203.
  16. Lorincz E, Erdei G, Péczeli I, Steinbach C, Ujhelyi F, Bükki T. Modeling and optimization of scintillator arrays for PET detectors. IEEE Trans Nucl Sci. 2010;57:48-54.
  17. Sarrut D, Bardiès M, Boussion N, Freud N, Jan S, Létang JM, Loudos G, Maigne L, Marcatili S, Mauxion T, Papadimitroulas P, Perrot Y, Pietrzyk U, Robert C, Schaart DR, Visvikis D, Buvat I. A review of the use and potential of the GATE Monte Carlo simulation code for radiation therapy and dosimetry applications. Med Phys. 2014 Jun;41(6):064301.
  18. National Electrical Manufacturers Association. NEMA Standards Publication NU 3-2004. Performance measurements and quality control guidelines for non-imaging intra-operative gamma probes. 2004.
  19. Ay MR, Zeraatkar N, Gorjizadeh N, Kaviani A, Farzaneh Far S, Sajedi S, Arabi H, Farahani M, Teimourian B. SURGEOGUIDE: a Gamma Probe for Localization of Sentinel Lymph Nodes. Eur J Nucl Med Mol Imaging. 2013;40 (Suppl 2):S211–S212.
  20. Kaviani S, Zeraatkar N, Sajedi S, Gorjizadeh N, Farahani M, Ghafarian P, El Fakhri G, Sabet H, Ay MR. Development and characterization of a compact hand-held gamma probe system, SURGEOGUIDE, based on NEMA NU3-2004 standards. J Instrum. 2016;11(12):T12004.
  21.  Kroese DP, Brereton T, Taimre T, Botev ZI. Why the Monte Carlo method is so important today. Wiley Interdiscip Rev Comput Stat. 2014;6(6):386-92.
  22. Tiourina T, Arends B, Huysmans D, Rutten H, Lemaire B, Muller S. Evaluation of surgical gamma probes for radioguided sentinel node localisation. Eur J Nucl Med. 1998 Sep;25(9):1224-31.
  23. Mariani G, Vaiano A, Nibale O, Rubello D. Is the "ideal" gamma-probe for intraoperative radioguided surgery conceivable? J Nucl Med. 2005 Mar;46(3):388-90.
  24. Sarikaya I, Sarikaya A, Reba RC. Gamma probes and their use in tumor detection in colorectal cancer. Int Semin Surg Oncol. 2008 Nov 19;5:25.
  25. Bolozdynya A, Vorobiev K, Evgrafova E, Zhukov K, Kantserov V, Sosnovtsev V, Filipov DE, Yagnyukova AK. A γ probe for radionuclide diagnostics of cancer. Instrum Exp Tech. 2015;58(1):153-7.
  26. Classe JM, Fiche M, Rousseau C, Sagan C, Dravet F, Pioud R, Lisbona A, Ferrer L, Campion L, Resche I, Curtet C. Prospective comparison of 3 gamma-probes for sentinel lymph node detection in 200 breast cancer patients. J Nucl Med. 2005 Mar;46(3):395-9.
  27. Halkar RK, Aarsvold JN. Intraoperative probes. J Nucl Med Technol. 1999 Sep;27(3):188-93; quiz 195-6.