Brouwer, O.R.

Founded on Halsted’s hypothesis of sequential tumor spread, selective biopsy of the tumor draining lymph nodes enables early detection of clinically occult nodal metastases while sparing patients the morbidity of an unnecessary lymph node dissection. Originally introduced for melanoma and breast cancer, the sentinel node (SN) biopsy is a multidisciplinary diagnostic procedure based on the injection of a radiocolloid followed by lymphatic mapping using lymphoscintigraphy and SPECT/CT to identify the SNs. Intraoperatively, SNs are traditionally localized using a gamma ray detection probe and a separate injection of blue dye to visualize the SNs. Over the last decade, the procedure has expanded to malignancies with lymphatic drainage to areas of more complex anatomy or located deeply in the abdomen. SN biopsy in these patients may be challenging and may benefit from additional intraoperative tools. This thesis focuses on the clinical introduction of novel multimodal approaches in order to help optimize the SN procedure

International Migration, Integration and Social Cohesion online publications

UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl)UvA-DARE (Digital Academic Repository)Innovating image-guided surgery: Introducing multimodal approaches forsentinel node detectionBrouwer, O.R.Publication date2013Link to publicationCitation for published version (APA):Brouwer, O. R. (2013). Innovating image-guided surgery: Introducing multimodal approachesfor sentinel node detection. [Thesis, fully internal, Universiteit van Amsterdam].General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s)and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an opencontent license (like Creative Commons).Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, pleaselet the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the materialinaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letterto: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. Youwill be contacted as soon as possible.Download date:10 Mar 2023TABlE of ConTEnTSCHAPTER 1 8 Introduction and outline of the thesisPART I: Hybrid radio- and fluorescence guided sentinel node biopsy 22CHAPTER 2 24 Comparing the hybrid fluorescent and radioactive tracer ICG-99mTc-nanocolloid with 99mTc-nanocolloid for sentinel node identification: A validation study using lymphoscintigraphy and SPECT/CTCHAPTER 3 40 Feasibility of sentinel node biopsy in head and neck melanoma using a hybrid radioactive and fluorescent tracerCHAPTER 4 54 Concomitant radio- and fluorescence-guided sentinel node biopsy in squamous cell carcinoma of the oral cavity using ICG-99mTc-nanocolloidCHAPTER 5 70 A hybrid radioactive and fluorescent tracer for sentinel node biopsy in penile carcinoma as a potential replacement for blue dyeCHAPTER 6 88 Image-guided sentinel node biopsy in 104 melanoma patients; a hybrid approach  CHAPTER 7 102 Intraoperative laparoscopic fluorescence guidance to the sentinel node in prostate cancer patients; clinical proof of concept of an intergated functional imaging approach using a multimodal tracerCHAPTER 8 118 Relation between intraprostatic tracer deposits and sentinel node mapping in prostate cancer patientsPART II: SPECT/CT as a 3D roadmap for intraoperative navigation 134CHAPTER 9 136 Lymphoscintigraphy and SPECT/CT in multicentric and multifocal breast cancer: does each tumor have a separate drainage pattern? Results of a Dutch Multi-center Study (MULTISENT)CHAPTER 10 148 SPECT/CT and a portable gamma camera for image guided laparoscopic sentinel node biopsy in testicular cancerCHAPTER 11 158 Lymphatic drainage from renal cell carcinoma along the thoracic duct visualized with SPECT/CTCHAPTER 12 170 Image navigation as a means to expand the boundaries of fluorescence-guided surgeryCHAPTER 13 188 Sentinel node biopsy guided by 3D SPECT/CT-based navigation: transferring molecular imaging to the operating roomPART III 198CHAPTER 14 200 Conclusions and future perspectives 200 Summary  (EN) 218 Samenvatting (NL) 214 Resumen (ESP) 222 Appendix:  230Clinical application of  SPECT/CT and intraoperative radioguided sentinel bode biopsy in cancers of the male reproductive system Phd Portfolio: list of publications and presentations 252 Dankwoord / Acknowledgements 262 Curriculum Vitae 270

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Innovating image-guided surgery: Introducing multimodal approaches for sentinel node detection

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Innovating image-guided surgery: Introducing multimodal approaches for sentinel node detection

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