VIDEO: Reducing resurgeries and salvage radiotherapies in surgical oncology using the AURA 10
31st January 2024
The PET-CT specimen imager by XEOS is being successfully used at Ghent University Hospital in breast conserving surgery
The XEOS AURA 10 is the world’s first specimen PET-CT imager. Bringing molecular imaging in a compact mobile unit directly to the operating room for the first time, it allows surgeons to assess specimens in real-time with the intention of reducing the need for resurgery or salvage radiotherapy.
Based in Ghent, Belgium, XEOS have developed excellent collaborations with local hospitals. In this latest video, Dr. Menekse Göker of Ghent University Hospital demonstrates the AURA 10’s clinical workflow in a patient diagnosed with invasive ductal carcinoma who underwent surgery with a sentinel lymph node resection.
Comprehensive workflow from injection to resection
Prior to surgery, the hospital administered a peritumoral injection of 99mTc-nanocolloid followed by lymphoscintigraphy to visualise the lymph node in the hospital’s Nuclear Medicine department. The patient was then taken to the operating room and injected with 18F18-FDG at 0.8 Mbq/kg, which is sufficient for specimen detection using the AURA 10. The unit is positioned in the operating room with the patient, whose details are loaded directly on the system after having been integrated with the hospital’s PACS.
The sentinel lymph node resection was then performed, and once resected, sutures were added to the tumour for orientation allowing it to be placed correctly and aligned in the AURA 10’s specimen container. Correct orientation is important to allow the surgeon to see where the positive margins are in relation to the resection cavity.
Real-time positive margin identification
The AURA 10 images the tumour with orthogonal planar radiographs displayed in seconds. Within two minutes, the CT images are reconstructed and visualised, and PET-CT images are acquired within ten minutes. The acquisitions can be rotated and viewed in 3D to evaluate radiotracer uptake in the specimen and areas of interest can be zoomed in for a detailed view of margin. Additionally, the Maximum Intensity Projection (MIP) view can be used to visualise microcalcifications, allowing comparisons with preoperative mammograms.
Acquired images are uploaded to PACS, enabling surgeons to review with other departments such as Nuclear Medicine and Radiology. In the case of the specimen taken in this video, a positive resection margin was identified on the inferior side, so a cavity shave to remove remaining cancerous tissue was taken from the patient.
Find out more
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