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Background  PET/CT lymphoscintigraphy using  89 Zr-nanocolloidal albumin has the potential to improve the preoperative identification of sentinel lymph nodes (SLNs), especially if located in the near proximity of the primary tumour. This study aims to demonstrate the feasibility of PET/CT lymphoscintigraphy followed by intraoperative detection of  89 Zr-nanocolloidal albumin containing SLNs with the use of a handheld high-energy gamma probe.    Methods  PET/CT lymphoscintigraphy was performed after peritumoural injection of  89 Zr-nanocolloidal albumin in five patients with oral cavity carcinoma planned for surgical resection. SLN biopsy procedure was performed 18 h later. SLNs were detected using detailed information of PET/CT and the high-energy gamma probe.    Results  In all patients, SLNs were identified on PET/CT lymphoscintigraphy. Intraoperative detection using the high-energy gamma probe was possible in 10 of 13 SLNs, at a short distance from the SLN.    Conclusions  This study demonstrates that intraoperative detection of SLNs containing  89 Zr-nanocolloidal albumin using a handheld high-energy gamma probe is feasible, but its clinical use and sensitivity seem to be limited.    Trial registration  CCMO NL37222.092.11

ejnmmi research

Feasibility of intraoperative detection of sentinel lymph nodes with 89-zirconium-labelled nanocolloidal albumin PET-CT and a handheld high-energy gamma probe