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After the development of a hand-held intraoperative device for 3D real-time imaging of radioactively labeled sentinel lymph nodes in the human body, we present our first experience with the newest version of the freehand single-photon emission computed tomography (SPECT) technology in the operating room. The freehand SPECT system combines a gamma probe and an optical infrared positioning system, and provides surgeons with 3D imaging including exact depth information of the radioactive target. This technology was used intraoperatively in a female breast cancer patient to localize the axillary sentinel lymph nodes. The data obtained with freehand SPECT correlate well with conventional lymphoscintigraphy and with data collected using a conventional hand-held probe. By offering fast real-time intraoperative imaging, the new freehand SPECT system might facilitate the detection and removal of the sentinel lymph node(s) in certain situations and can be used for documentation and quality assurance purposes.

Showcase of Intraoperative 3D Imaging of the Sentinel Lymph Node in a Breast Cancer Patient using the New Freehand SPECT Technology