@article {ORSARIA101, author = {PAOLO ORSARIA and AGOSTINO CHIARAVALLOTI and ALESSANDRO FIORENTINI and CHIARA PISTOLESE and GIANLUCA VANNI and ALESSANDRA VITTORIA GRANAI and DIMITRIOS VARVARAS and ROBERTA DANIELI and ORAZIO SCHILLACI and GIUSEPPE PETRELLA and ORESTE CLAUDIO BUONOMO}, title = {PET Probe-Guided Surgery in Patients with Breast Cancer: Proposal for a Methodological Approach}, volume = {31}, number = {1}, pages = {101--110}, year = {2017}, publisher = {International Institute of Anticancer Research}, abstract = {Background: Although it is valuable for detecting distant metastases, identifying recurrence, and evaluating responses to chemotherapy, the role of 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (18F-FDG PET/CT) in assessing locoregional nodal status for initial staging of breast cancer has not yet been well-defined in clinical practice. In the current report, we describe a new PET probe-based clinical approach, with evaluation of the technical performance of a handheld high-energy gamma probe for intraoperative localization of breast carcinomas, and evaluation of lymph node metastases during radio-guided oncological surgery. Patients and Methods: Three patients underwent a PET/CT scan immediately prior to surgery following the standard clinical protocol. Intraoperatively, tumors were localized and resected with the assistance of a hand-held gamma probe. PET-guided assessment of the presence or absence of regional nodal spread of malignancy was compared with the reference standard of histopathological examination. Results: In all three cases, perioperative 18F-FDG PET/CT imaging and intraoperative gamma probe detection verified complete resection of the hypermetabolic lesions and demonstrated no additional suspicious occult disease. Conclusion: This innovative approach demonstrates great promise for providing real-time access to metabolic and morphological tumor information that may lead to an optimal disease-tailored approach. In carefully selected indications, a PET probe can be a useful adjunct in surgical practice, but further trials with a larger number of patients need to be performed to verify these findings.}, issn = {0258-851X}, URL = {https://iv.iiarjournals.org/content/31/1/101}, eprint = {https://iv.iiarjournals.org/content/31/1/101.full.pdf}, journal = {In Vivo} }