Development of a leakage monitoring system in isolated limb perfusion with portable gamma camera.

Autor: Agudo Martínez A; Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España. Electronic address: ana.agudo.sspa@juntadeandalucia.es., Calvo Morón C; Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España., Cambil Molina T; Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España., García Gómez FJ; Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España., de la Riva Pérez PA; Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España., de la Cruz Merino L; Servicio de Oncología Médica, Hospital Universitario Virgen Macarena, Sevilla, España., Araji Tiliani O; Servicio de Cirugía Cardiovascular, Hospital Universitario Virgen Macarena, Sevilla, España., Terrón León JA; Servicio de Radiofísica, Hospital Universitario Virgen Macarena, Sevilla, España., Castro Montaño J; Servicio de Medicina Nuclear, Hospital Universitario Virgen Macarena, Sevilla, España.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de medicina nuclear e imagen molecular [Rev Esp Med Nucl Imagen Mol (Engl Ed)] 2021 Jan-Feb; Vol. 40 (1), pp. 4-11. Date of Electronic Publication: 2020 Aug 21.
DOI: 10.1016/j.remn.2020.06.018
Abstrakt: Isolated limb perfusion (ILP) is a method for treating unresectable lesions of limbs in patients with melanoma or sarcoma by using high doses of tumor necrosis factor alpha and melphalan. These high doses can result in high systemic toxicity if there is a drug leak from the isolated circulation of the limb to the systemic. This makes it imperative to monitor the leakage rate (F[%]) during the infusion, currently performed with radiotracers. The objective of this work was to develop a leakage monitoring protocol as accurate as possible to ensure safe ILP.
Material and Method: We built a phantom with 3compartments (body, limb and precordial area) and a high sensitivity collimator fitted to a portable gammacamera. We simulate ILP with scheduled leaks every 10minutes from 1% to 9% (theorical F[%]). We mesured F(%) using 2equation: one is the proposed in the literature and another corrected by decay of the radioisotope. We test the optimal radiopharmaceutical doses to minimize the detector dead time error and compare F(%) mesured by both equations regarding the theoretical F(%). The leakage monitoring protocol was used in 17 ILP of 16 patients and an analysis of the recorded data was performed.
Results: We found significant differences between F(%) mesured using the first equation and theoretical F(%), obtaining results very adjusted to the theorical after applying the decay correction.
Conclusions: The decay correction of the radioisotope is a simple manner to carry out the procedure more safely, reducing the error in the calculation of F(%).
(Copyright © 2020 Sociedad Española de Medicina Nuclear e Imagen Molecular. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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