Monitoring system for isolated limb perfusion based on a portable gamma camera

Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-alpha) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular terr...

Descripción completa

Detalles Bibliográficos
Autores: Pavón Hernández, Noriel, Orero, Abel, Vidal-Sicart, S., Roe, N., Muxi, A., Rubí Sureda, Sebastià, Duch, Joan, Rull, Ramón, Pons, F., Pavía, Javier
Tipo de recurso: artículo
Fecha de publicación:2009
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:DIGITAL.CSIC. Repositorio Institucional del CSIC
OAI Identifier:oai:digital.csic.es:10261/20854
Acceso en línea:http://hdl.handle.net/10261/20854
Access Level:acceso abierto
Palabra clave:Limb perfusion
melphalan
Tumour necrosis factor alfa
Radiotracer
Gamma camera
Leakage monitoring
id ES_e89ecda2e3ad64c558d6a36123d76bdf
oai_identifier_str oai:digital.csic.es:10261/20854
network_acronym_str ES
network_name_str España
repository_id_str
spelling Monitoring system for isolated limb perfusion based on a portable gamma cameraPavón Hernández, NorielOrero, AbelVidal-Sicart, S.Roe, N.Muxi, A.Rubí Sureda, SebastiàDuch, JoanRull, RamónPons, F.Pavía, JavierLimb perfusionmelphalanTumour necrosis factor alfaRadiotracerGamma cameraLeakage monitoringBackground: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-alpha) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-alpha and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is +/- 1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-alpha and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-alpha and melphalan has been indicated.Peer reviewedSchattauer201020102009info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_650122195 bytesapplication/pdfhttp://hdl.handle.net/10261/20854reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Ingléshttp://dx.doi.org/10.3413/nukmed-0223info:eu-repo/semantics/openAccessoai:digital.csic.es:10261/208542026-05-22T06:33:51Z
dc.title.none.fl_str_mv Monitoring system for isolated limb perfusion based on a portable gamma camera
title Monitoring system for isolated limb perfusion based on a portable gamma camera
spellingShingle Monitoring system for isolated limb perfusion based on a portable gamma camera
Pavón Hernández, Noriel
Limb perfusion
melphalan
Tumour necrosis factor alfa
Radiotracer
Gamma camera
Leakage monitoring
title_short Monitoring system for isolated limb perfusion based on a portable gamma camera
title_full Monitoring system for isolated limb perfusion based on a portable gamma camera
title_fullStr Monitoring system for isolated limb perfusion based on a portable gamma camera
title_full_unstemmed Monitoring system for isolated limb perfusion based on a portable gamma camera
title_sort Monitoring system for isolated limb perfusion based on a portable gamma camera
dc.creator.none.fl_str_mv Pavón Hernández, Noriel
Orero, Abel
Vidal-Sicart, S.
Roe, N.
Muxi, A.
Rubí Sureda, Sebastià
Duch, Joan
Rull, Ramón
Pons, F.
Pavía, Javier
author Pavón Hernández, Noriel
author_facet Pavón Hernández, Noriel
Orero, Abel
Vidal-Sicart, S.
Roe, N.
Muxi, A.
Rubí Sureda, Sebastià
Duch, Joan
Rull, Ramón
Pons, F.
Pavía, Javier
author_role author
author2 Orero, Abel
Vidal-Sicart, S.
Roe, N.
Muxi, A.
Rubí Sureda, Sebastià
Duch, Joan
Rull, Ramón
Pons, F.
Pavía, Javier
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Limb perfusion
melphalan
Tumour necrosis factor alfa
Radiotracer
Gamma camera
Leakage monitoring
topic Limb perfusion
melphalan
Tumour necrosis factor alfa
Radiotracer
Gamma camera
Leakage monitoring
description Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-alpha) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-alpha and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is +/- 1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-alpha and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-alpha and melphalan has been indicated.
publishDate 2009
dc.date.none.fl_str_mv 2009
2010
2010
dc.type.none.fl_str_mv info:eu-repo/semantics/article
http://purl.org/coar/resource_type/c_6501
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10261/20854
url http://hdl.handle.net/10261/20854
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv http://dx.doi.org/10.3413/nukmed-0223
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 22195 bytes
application/pdf
dc.publisher.none.fl_str_mv Schattauer
publisher.none.fl_str_mv Schattauer
dc.source.none.fl_str_mv reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC
instname:Consejo Superior de Investigaciones Científicas (CSIC)
instname_str Consejo Superior de Investigaciones Científicas (CSIC)
reponame_str DIGITAL.CSIC. Repositorio Institucional del CSIC
collection DIGITAL.CSIC. Repositorio Institucional del CSIC
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869422957634256896
score 15,812429

Similares en LA Referencia