The present report describes a novel navigation technique using Vnav-PET/CT, which delivers image fusion of US with PET/CT. To identify the axillary targets using Vnav-PET/CT, we set at least two landmarks then injected 0.2 ml viscous blue dye in and around the capsule, which resulted in precise resection. Case 1: A 53-year-old woman with 2 PET/CT-positive lymph nodes in the right axilla underwent easy identification of the targets using the navigation technique followed by lymph node dissection. Among 32 lymph nodes dissected, only the two lymph nodes stained by blue dye were shown histologically to be malignant. Case 2: A 68-year-old woman had a PET/CT-positive lymph node in the left axilla. Vnav-PET/CT easily identified the target, which was successfully dissected under local anaesthesia.
This navigation and marking using Vnav-PET/CT helped us easily approach the target, resulted in less surgical time, and avoided unsatisfactory axillary complications. These advances of the navigation system enable us to perform precise minimally invasive surgery.
This is the first report of navigation surgery using Vnav-PET/CT, which may assist minimally invasive procedures, especially in the axilla.