Sergi Vidal-Sicart

Hospital Clínic de Barcelona · Servicio de Medicina Nuclear

Background Predictors of response to neoadjuvant chemotherapy (NACT) and endocrine therapy (NET) in hormone receptor-positive (HoR+)/human epidermal growth factor receptor 2 (HER2)-negative breast cancer (BC) are required. Also, pathological and molecular changes induced by both strategies and their impact on patients’ outcomes have not been report...

Background/Objectives: The aim of the study was to determine the clinical value of the sentinel lymph node ratio (SLN-R) in predicting additional positive lymph nodes during axillary lymph node dissection (ALND) in breast cancer patients following neoadjuvant chemotherapy (NAC). Methods: A cross-sectional study was performed at a single institution...

Background: Breast cancer (BC) recurrence, defined as the reappearance of cancer in the ipsilateral breast after primary treatment, poses significant challenges in clinical management. Despite advances in treatment, recurrence rates persist, ranging from 0.6 to 1.5% annually, reaching 10–15% at 20 years. This study aims to analyze the surgical and...

Background The characterization and comparison of gene expression and intrinsic subtype (IS) changes induced by neoadjuvant chemotherapy (NACT) and endocrine therapy in hormone receptor-positive (HR+)/human epidermal growth factor receptor 2 (HER2)-low versus HR+/HER2-0 breast cancer (BC) has not been conducted so far. Most evidence on the associat...

Introduction/Background Sentinel lymph node (SLN) detection in early-stage epithelial ovarian cancer (EOC) has been investigated in various trials, showing disparities in detection outcomes. Evidence suggests that using a combination of two tracers (radiotracer and indocyanine green (ICG)) yields enhanced results compared to using a single tracer....

Introduction/Background Multiple studies have shown the accuracy and feasibility of sentinel lymph node (SLN) biopsy in early-stage disease. However, there is no prospective evidence on long-term oncological safety yet. We report the results from our center comparing the SLN alone with SLN and PLD. Methodology Women who underwent radical surgery f...

Background Neoadjuvant chemotherapy (NACT) and endocrine therapy (NET) are sometimes used to shrink hormone receptor-positive (HoR+)/HER2-negative breast cancer (BC) before surgery. These treatments can change the tumor on a molecular level, but the impact on patient outcomes remains unclear. There is also a lack of detailed comparison between the...

Purpose The recently introduced tethered DROP-IN gamma probe has revolutionized the way robotic radioguided surgery is performed, fully exploiting the nature of steerable robotic instruments. Given this success, the current first-in-human study investigates if the DROP-IN can also provide benefit in combination with steerable non-robotic instrument...

Purpose The aim of this review is to give an overview of the current status of molecular image–guided surgery in gynaecological malignancies, from both clinical and technological points of view. Methods A narrative approach was taken to describe the relevant literature, focusing on clinical applications of molecular image–guided surgery in gynaeco...

Radioguidance that makes use of β-emitting radionuclides is gaining in popularity and could have potential to strengthen the range of existing radioguidance techniques. While there is a strong tendency to develop new PET radiotracers, due to favorable imaging characteristics and the success of theranostics research, there are practical challenges t...

Background: The characterization and comparison of gene expression (GE) and intrinsic subtypes (IS) changes induced by neoadjuvant chemotherapy (NACT) and endocrine therapy (NET) in hormone receptor-positive(HR+)/HER2-low vs. HR+/HER2-0 breast cancer (BC) has not been conducted so far. Most evidence on the association of HER2 status with pathologic...

Background The current expansion of image-guided surgery is closely related to the role played by radio-guided surgery in supporting the sentinel node (SN) procedure during more than three decades. The so-called triple approach (lymphoscintigraphy, gamma probe detection and blue dye) was not only essential in the seminal validation of the SN proced...

Purpose Prostate-specific membrane antigen (PSMA) is increasingly considered as a molecular target to achieve precision surgery for prostate cancer. A Delphi consensus was conducted to explore expert views in this emerging field and to identify knowledge and evidence gaps as well as unmet research needs that may help change practice and improve onc...

Introduction/Background Systematic pelvic and para-aortic lymphadenectomy is part of the staging surgery in early-stage ovarian cancer (EOC) to determine the prognosis and indicate adjuvant treatment. However, this procedure is associated with potential severe morbidity. The Mapping Sentinel Lymph Node In early-Stage Ovarian Cancer (MELISA) trial a...

Introduction/Background Primary vaginal malignant melanoma is an extremely rare and very aggressive tumor with a 5-year survival rate of 5%-25%. The approach to this disease is a challenge, since staging and treatment data is limited, and the prognosis is poor. Lymph node status and mitotic rate should be assessed as they are the most important pre...

Background A systematic pelvic and para-aortic lymphadenectomy remains the surgical standard management of early-stage epithelial ovarian cancer. Sentinel lymph node mapping is being investigated as an alternative procedure; however, data reporting sentinel lymph node performance are heterogeneous and limited. Objective A systematic pelvic and par...

The introduction of the tethered DROP‐IN gamma probe has enabled targeted robot‐assisted radioguided prostate cancer (PCa) resection of pelvic sentinel lymph nodes (SLNs) and prostate‐specific membrane antigen (PSMA)‐positive lesions. While both procedures use 99m Tc‐isotopes, the two vary in signal and background intensity. To understand how the d...

Nuclear medicine has significantly contributed to precision surgery in breast cancer in the past decades. Radioguided surgery (RGS) has enabled sentinel node (SN) biopsy in assessing regional nodal involvement modifying the management of patients with early breast cancer. For the axilla the SN procedure has resulted in fewer complications and bette...

Background: This study evaluated the safety and performance of a drop-in gamma probe for prostate cancer (PCa) sentinel lymph node biopsy (SeLNB) in a prospective, open-label, multicentre, single-arm clinical trial. Objective: The main objective was to determine the sentinel lymph node (SeLN) detection rate with the drop-in gamma probe system. T...

Purpose Although multiple radiopharmaceuticals are currently available for sentinel node (SN) biopsy, 99mTc-tilmanocept is of particular interest due to its low molecular weight and specific binding capability for the mannose receptors of lymphatic reticuloendothelial cells. In the current systematic review and meta-analysis, we aimed to provide an...

Molecular imaging technologies are increasingly used not only to diagnose, monitor and guide cancer treatment, but also to intraoperatively identify disease. Radioguided surgery (RGS), one of the earliest and still most used forms of interventional molecular imaging, allows selective resection of tissues previously marked with a radiotracer (molecu...

Background: Adjuvant radiotherapy and hormonotherapy after breast-conserving surgery (BCS) in ductal carcinoma in situ (DCIS) have been shown to reduce the risk of local recurrence. To predict the risk of ipsilateral breast tumor relapse (IBTR) after BCS, the Memorial Sloan Kettering Cancer Center (MSKCC) developed a nomogram to analyze local recu...

Expert representatives from 11 professional societies, as part of an autonomous work group, researched and developed appropriate use criteria (AUC) for lymphoscintigraphy in sentinel lymph node mapping and lymphedema. The complete findings and discussions of the work group, including example clinical scenarios, were published on October 8, 2022, an...

Background In clinically node-negative (cN0) early stage breast cancer (EBC) undergoing primary systemic treatment (PST), post-treatment positive sentinel lymph node (SLN+) directs axillary lymph node dissection (ALND), with uncertain impacts on outcomes and increased morbidities. Patients and Methods We conducted an observational study on imaging...

Background: Some studies suggested that the patients included in the Z0011 trial may represent patients with ultrasound-negative axillary nodes and axillary invasion diagnosed by sentinel node (SN) biopsy. Nevertheless, the National Comprehensive Cancer Network (NCCN) guidelines recommend SN mapping if 1 or 2 suspicious lymph nodes are identified...

Purpose: This study evaluated the performance of a drop-in gamma probe for prostate cancer (PCa) sentinel lymph node dissection (SLND) in a pelvic phantom, porcine model, and in PCa patients as part of an ongoing prospective multicenter clinical trial. Methods: Two design variants of the drop-in gamma probe (SENSEI; Lightpoint Medical Ltd) were...

Background CDK4/6 inhibitors (CDKi), namely, palbociclib, ribociclib, and abemaciclib, combined with either an aromatase inhibitor (AI) or fulvestrant are the standard first/second line for hormone receptor-positive(HR+)/HER2-negative(neg) metastatic breast cancer (MBC). However, the choice of one specific CDKi is arbitrary and based on the physici...

Resumen Presentamos la visión futurista que de su especialidad tienen 7 líderes de opinión estrechamente comprometidos con la patología mamaria. Las especialidades incluidas fueron radiología, patología, cirugía, cirugía plástica, medicina nuclear, oncología médica y oncología radioterápica. Los autores plasman, en este artículo, sus opiniones y cr...

Background: Primary hyperparathyroidism is a common endocrine disorder produced by the increase of parathyroid hormone (PTH) due to a benign adenoma of a single parathyroid gland, or as multiple gland hyperplasia, or as a rare malignant tumor. Preoperative imaging scans are frequently necessary for the minimally invasive parathyroidectomies to ide...

Background: Histological diagnosis of pulmonary nodules requires surgical resection on many occasions. There are multiple localization strategies each with their own benefits and complications. The objective of this study is to compare preoperative lung nodule localization with hookwire and radiotracer injection (radioguided occult lesion localiza...

Radioguided surgery for head and neck cancer has emerged as an important field of interventional nuclear medicine. Currently, the two most important applications concern sentinel lymph node (SLN) biopsy for cutaneous melanoma and oral cavity squamous cell carcinoma (OCSCC). An emerging application is SLN biopsy in thyroid cancer. Similar to other a...

The dynamic concept Guided intraOperative Scintigraphic Tumour Targeting (GOSTT) was introduced a few years ago to encompass all developments in the area of interventional nuclear medicine. This concept includes the use of both preoperative imaging required for providing roadmaps for radioguided surgery and specific intraoperative detection modalit...

Melanoma is one of the most aggressive and therapy-resistant cancers and its incidence is continuously increasing worldwide. The metastatic involvement of lymph nodes is of utmost importance for prognosis in patients with intermediate-thickness melanoma. Other prognostic factors include tumor thickness, presence of ulceration, and mitotic rate. Rad...

Sentinel lymph node biopsy is the standard surgical procedure for staging clinically tumor-free regional nodes in patients with early-stage breast cancer. This technique has spared the additional morbidity of axillary lymph node dissection without compromising diagnostic accuracy and prognostic information. However, it is still important to discuss...

Objectives To determine the accuracy of nodal staging in patients with prostate cancer (PCa) when ⁹⁹ m Tc-nanocolloid radiotracer is injected into an index lesion (IL). Methods This prospective study was conducted at our institution between June 2016 and October 2020. It included 64 patients with localized PCa with at least a 5% possibility for ly...

Resumen La estadificación ganglionar inicial está indicada en aquellos casos de carcinoma de mama en los que la información obtenida pueda cambiar la actitud terapéutica o establecer una información pronóstica con implicaciones para el seguimiento de las pacientes. En los últimos años, los cambios conceptuales introducidos por ensayos clínicos y es...

Epithelial ovarian cancer is the sixth leading cause of death among women in Europe and the leading cause of death from gynecological cancer. Patients with initial clinical stage EOC have a lymph node involvement rate of 10–30%. The double ovarian vascularization that accompanies lymphatic drainage explains the high complexity of lymphatic drainage...

This tumor has a progressive locoregional spread, with a relatively low incidence of distant metastases. Four dissemination ways are known (direct extension to adjacent structures; transtubal, lymphatic, and hematogenous). Currently, there are two systems for staging endometrial cancer (the FIGO system, which is the most commonly used, and the AJCC...

Importance: Sentinel lymph node (SLN) biopsy is a standard staging procedure for cutaneous melanoma. Regional disease control is a clinically important therapeutic goal of surgical intervention, including nodal surgery. Objective: To determine how frequently SLN biopsy without completion lymph node dissection (CLND) results in long-term regional...

The surgical approach to different pathologies, not only oncological, has evolved. As Veronesi's group has coined very graphically, we are moving from “maximum tolerable treatments to minimum effective treatments” and this journey cannot be carried out in any other way than through a multidisciplinary and multimodality approach. Multidisciplinary,...

The surgical approach to different pathologies, not only oncological, has evolved. As Veronesi's group has coined very graphically, we are moving from “maximum tolerable treatments to minimum effective treatments” and this journey cannot be carried out in any other way than through a multidisciplinary and multimodality approach. Multidisciplinary,...

Breast cancer is the most frequent cancer diagnosed in women worldwide. Accurate lymph node staging is essential for both prognosis (of early-stage disease) and treatment (for regional control of disease) in patients with breast cancer. The sentinel lymph nodes are the regional nodes that directly drain lymph from the primary tumor. No imaging moda...

Introduction In 2019 the opportunity to add a nurse within the radioguided surgery (RGS) team was generated. The referent nurse model was adapted to, the sentinel node (SN) preoperative approaches. Objectives To describe the process performed to define the sentinel node referent nurse (SNRN) profile, to validate its practical application and to es...

Resumen El diagnóstico cada vez más precoz de la enfermedad mamaria y el uso más extendido del tratamiento sistémico primario conlleva en la práctica clínica un creciente número de cirugías de lesiones mamarias no palpables (LMNP). La cirugía conservadora de la mama requiere a menudo la utilización de un procedimiento de localización preoperatorio...

The increasingly early diagnosis of breast disease and the more widespread use of primary systemic therapy leads to an increasing number of surgeries for non-palpable breast lesions (NPL) in clinical practice. Breast-conserving surgery often requires the use of an image-guided preoperative localization procedure, in which a device is placed within...

Following its incorporation SPECT/CT has become an important component in the imaging protocol of the sentinel node (SN) procedure. SPECT/CT does not replace lymphoscintigraphy. The primary goal of SPECT/CT is to anatomically localize SNs already visualized on planar images. However, due to its high sensitivity SPECT/CT can also detect additional S...