Equipamento brasileiro para detecção gama intra-operatória na identificação de linfonodo sentinela
Arquivos
Data
2008
Autores
Santos, Paula Cristina Fada dos 
Orientadores
Santos, Ivan Dunshee de Abranches Oliveira
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Os equipamentos disponíveis para a realização da detecção gama intra-operatória são importados e de alto custo. Com o objetivo de diminuir os custos de aquisição e manutenção do equipamento, o Instituto de Pesquisa Enegérticas e Nucleares desenvolveu um equipamento brasileiro de detecção gama intra-operatória, que consiste de uma sonda
radioguiada. Objetivo: Testar equipamento brasileiro de detecção gama intra-operatória na identificação de linfonodo sentinela. Métodos: Foram utilizados 30 ratos adultos jovens. Depois de anestesiados, os animais foram distribuídos em dois grupos de 15 animais cada. O grupo A recebeu
radiofármaco Dextran 500 – Tc99m e Azul Patente V. O grupo C recebeu
somente Azul Patente V. O grupo A foi submetido a medição da captação
radioativa de fundo, do sítio de injeção e do linfonodo sentinela ex vivo.
Essas medições foram realizadas pelos dois equipamentos. Após a exerese,
cada linfonodo do grupo A e do grupo C foram dispostos aleatoriamente
em nova seqüência e procedeu-se à leitura com medição da radioatividade
com os dois equipamentos. Foram aplicados o teste de Mann-Whitney, o
teste t pareado de Student e o Alfa de Cronbach. Resultados: Tanto o
equipamento do Instituto de Pesquisa Energéticas e Nucleares como o
equipamento importado localizaram o Linfonodo Sentinela. Os valores de
captação da radiação gama de cada Linfonodo Sentinela ex vivo
demonstraram alfa de Cronbach com alta consistência interna dos dados
(0,9188).
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O equipamento do Instituto de Pesquisa Energéticas e Nucleares
detectou radiação mesmo nos linfonodos que não receberam o
radiofármaco. Na região do sítio de injeção observou-se diferença entre os
pares de resultados dos dois aparelhos (p=0,0013), o teste de MannWhitney
não foi capaz de detectar diferenças entre os dois grupos de
resultados. Conclusão: O equipamento brasileiro de detecção gama intraoperatória
identifica o linfonodo sentinela e mostra falsos positivos.
Introduction: The Intraoperatory Gamma Detection equipment available in Brazil is imported and expensive, which may limit its use. The Nuclear Energy Research Institute has developed a national and more affordable piece of equipment. Objective: Test equipament Brazilian of intraoperatory gamma detection in the identification of sentinel lymph node. Methods: thirty young adult male rats were studied. After anesthetized, animals were divided into two groups of 15 animals each. Animals from group A received dextram 500 - Tc99 radiopharmaceutical and patent blue V and those from group C received only patent blue V to map the lymphatic drainage. The presence of radiation in the background area, in the area of injection and of the ex vivo sentinel lymph node of group A were measured. After the exeresis, each lymph node in group A and in group B was mixed forming a new random sequence and the radioactive reading of each lymph node was carried out, using both pieces of equipment. Results: The hottest sentinel lymph node was identified by the Brazilian equipment when radiation was measured in the area of limphatic drainage after the Dextran 500 was injected. Also, the ex vivo sentinel lymph node was evaluate by both intraoperatory gamma detection pieces of equipment. The brazilian equipment has also detected radiation in the lymph nodes that had not received radiopharmaceutical, leading to false positive, checked in the application of Mann-Whitney tests and Student’s paired t-tests. The Cronbach alpha has shown high internal consistency of data (0,9416). Conclusions: The brazilian equipment of intraoperatory gamma detection identifies the lymph and shows false positives.
Introduction: The Intraoperatory Gamma Detection equipment available in Brazil is imported and expensive, which may limit its use. The Nuclear Energy Research Institute has developed a national and more affordable piece of equipment. Objective: Test equipament Brazilian of intraoperatory gamma detection in the identification of sentinel lymph node. Methods: thirty young adult male rats were studied. After anesthetized, animals were divided into two groups of 15 animals each. Animals from group A received dextram 500 - Tc99 radiopharmaceutical and patent blue V and those from group C received only patent blue V to map the lymphatic drainage. The presence of radiation in the background area, in the area of injection and of the ex vivo sentinel lymph node of group A were measured. After the exeresis, each lymph node in group A and in group B was mixed forming a new random sequence and the radioactive reading of each lymph node was carried out, using both pieces of equipment. Results: The hottest sentinel lymph node was identified by the Brazilian equipment when radiation was measured in the area of limphatic drainage after the Dextran 500 was injected. Also, the ex vivo sentinel lymph node was evaluate by both intraoperatory gamma detection pieces of equipment. The brazilian equipment has also detected radiation in the lymph nodes that had not received radiopharmaceutical, leading to false positive, checked in the application of Mann-Whitney tests and Student’s paired t-tests. The Cronbach alpha has shown high internal consistency of data (0,9416). Conclusions: The brazilian equipment of intraoperatory gamma detection identifies the lymph and shows false positives.
Descrição
Citação
SANTOS, Ivan Dunshee de Abranches Oliveira. Equipamento brasileiro para detecção gama intra-operatória na identificação de linfonodo sentinela. 2008. 73 f. Dissertação (Mestrado em Ciências)-Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2008.