Project: REAL TIME AND 3D NAVIGATION SYSTEM FOR SENTINEL NODE DETECTION AND PRECISE LOCALIZATION IN THE OPERATING ROOM

Background_x000D_ _x000D_ Worldwide, breast cancer comprises 10.4% of all cancer incidences among women, making it the most common type of non-skin cancer in women and the fifth most common cause of cancer death. In 2004, breast cancer caused 519,000 deaths worldwide (7% of cancer deaths; almost 1% of all deaths). _x000D_ _x000D_ The treatment of breast cancer involves the elimination of the cancerous lump and affected lymphatic nodes. The localization of these nodes has been the base of numerous studies and the development of specific technology and devices._x000D_ _x000D_ Once a tumour has been detected it is important not only to extract it but also to localize and extract the lymphatic nodes associated with it, since the tumour usually expands to other organs (metastasis) through the lymphatic system. It is therefore critical to localize which nodes are connected with the tumour and to determine out of them which ones are already invaded by tumour cells. _x000D_ _x000D_ This procedure is currently performed in the European hospitals by finding out the nodes associated with the tumour by means of a gammaprobe, extracting those and sending them to the pathologic anatomy lab for histological determination._x000D_ _x000D_ Gamma probes have made a major contribution to the early development of radio-guided surgery, but have many technical and clinical limitations which have restricted their use to relatively few experts, nuclear physicians and surgeons from different specialities, in a very small percentage of hospitals and types of malignancies. Blue ink of different types is still routinely used by many specialists, who always appreciated the need to see where the tumour is expanding. Radio-guided surgery with probes has not been able to help the vast majority of patients who should benefit from it. _x000D_ _x000D_ GEM IMAGING has developed a gamma camera to find the sentinel nodes in the operating room through images obtained in real time. This method works well in determining which nodes have to be extracted. However, the images obtained by the gamma camera are planar (2D) and, therefore, the surgeon does not know the depth where the nodes are located. Though, it is very important to know the precise location of the nodes in three dimensions._x000D_ _x000D_ Motivation_x000D_ _x000D_ In order to solve this problem, we propose an innovative system to precisely localize in real time and in three dimensions the nodes connected to the tumour and to determine inside the operating room which ones are already invaded with tumour cells._x000D_ _x000D_ Localization will be accomplished by integrating a tracking device in the system, allowing to determine the position and orientation of the gammacamera while it is acquiring. The surgeon will move the camera at will, capturing 2D gammagraphies from different orientations. Acquired data and their associated spatial coordinates are processed by means of an innovative 3D reconstruction algorithm in order to determine the location of the activity sources along with their morphology._x000D_ _x000D_ Three-dimensional images, fused with live video streaming, will be presented to the surgeon through Augmented Reality techniques. The video will complete the functional information provided by the gammagraphy data with optical information, allowing the surgeon to localize the lymphatic nodes in real time._x000D_ _x000D_ Summary_x000D_ _x000D_ This project proposes an innovative method for generating intrasurgical, real-time gammagraphies, fussing them with real-time structural patient information. Resulting images will be shown to the surgeon from his point of view. _x000D_ _x000D_ The CO goal of this innovative system design is an improved accuracy in nodes localization. At the same time, it will be an extremely intuitive tool.

Acronym 3DSENTINEL (Reference Number: 6560)
Duration 01/06/2011 - 30/05/2014
Project Topic It is proposed innovative systems to precisely localize in real time, and in 3D, lymphatic nodes connected to the tumour and to determine, inside the operating room, which ones are already invaded with tumour cells.
Project Results
(after finalisation)
The results of the project were not good._x000D_The Italian software P did not participate on the project and Oncovision took over their part. But they have no experianse in software developments which mean that they were not able to coordinate the whole periphery equipment not to speak about the 3D imaging...
Network Eurostars
Call Eurostars Cut-Off 6

Project partner

Number Name Role Country
4 Trivisio Prototyping GmbH Partner Germany
4 University Hospital Essen, Department of Dermatology Partner Germany
4 Oncovision, GEM-Imaging S.A. Coordinator Spain
4 Seac02 S.r.l. Observer Italy