Gamma probe
A gamma probe is a handheld device used with a Geiger-Muller tube or scintillation counter, for intraoperative use following interstitial injection of a radionuclide, to locate regional lymph nodes by their radioactivity.[1] It is used primarily for sentinel lymph node mapping and parathyroid surgery. The Gamma Probe is also used for RSL (Radioactive Seed Localization), to locate small and non-palpable breast lesions.
History
The sentinel node market experienced high growth in the early and mid 90's starting with melanoma sentinel node surgical search and breast cancer sentinel node staging; both are currently considered standards of care. Most surgeons propose node staging after a positive breast biopsy. New applications are being developed for parathyroid direct detection and intra-operative detection of cancerous tissue using tumor-seeking radiopharmaceuticals. Parathyroid detection is growing fast, while the intraoperative use of gamma probes for direct tumor detection is just emerging.
Quality Criteria
To evaluate the quality of a gamma probe system one must measure or discuss the following parameters:
- Spatial selectivity
- Spatial resolution
- Maximum sensitivity
- Quality of shielding
- Energy resolution and spectral discrimination
- Display of signal
Competition
The following companies manufacture gamma probes:[2]
Company | Device Control Unit | PET Capable | Origin Country | Company Website | Worldwide Market Share |
---|---|---|---|---|---|
Dilon Diagnostics | Navigator | yes | MA, USA | rmdmedical.com | 45% |
Devicor Medical Products, Inc. | Neoprobe | yes | OH, USA | Mammotome.com | 35% |
Care Wise Medical | C-Trak | yes | CA, USA | carewise.com | 15% |
IntraMedical Imaging | Node Seeker | yes | CA, USA | gammaprobe.com | 1% |
Oncovision | WProbe | ? | Spain | oncovision.com | 1% |
CLERAD | Gamma Sup | yes | France | clerad.fr | <1% |
Eurorad SA | Euro Probe | ? | France | em-instruments.com | 1% |
World of Medicine | Gamma Finder | ? | Germany | gammafinder.com | 1% |
Nucleo Med (Pol.Hi.Tech) | Nucleo Probe | ? | Italy | scintiprobe.com | <1% |
DeLong Instruments | DiSurpro | ? | Czech Republic | dicomps.com | <1% |
Nuclear Lab | DGC II | ? | Argentina | nuclearlab.com | <1% |
GFE Service | Gamma Locator DXI | yes | Germany | gfe-service.de | <1% |
Crystal Photonics GmbH | Crystal Probe | yes | Germany | surgicalprobe.com
crystal-photonics.com |
<1% |
Silicon Sensor Intl. | SIS System | yes | Germany | silicon-sensor.com | <1% |
Gammasonics | Gamma Probe Explorer | yes | Australia | gammasonics.com | <1% |
Parto Negar Persia | SURGEOGUIDE | yes | Iran | pnpmed.com | <1% |
Isotopes for clinical use with Gamma Probes
- Tc99m - Technetium-99m
- I125 - Iodine 125
- I131 - Iodine 131
- In111 - Indium 111
- F18 - Fluorine 18
- Ga68 - Gallium 68
Calibration / Test Isotopes used with Gamma Probes
- Co57 - Cobalt 57
- Na22 - Sodium 22