Technical innovations

A multimodality localization technique for radio-guided surgery

Seza A Gulec , Erica Hoenie and Kristan Rheinheimer

Goshen cancer Institute at Goshen Health System, Goshen, IN, USA

author email corresponding author email

World Journal of Surgical Oncology 2007, 5:43doi:10.1186/1477-7819-5-43

Published:	25 April 2007

Abstract

Background

Intraoperative localization of image or endoscopy-detected lesions occasionally pose surgical challenges due to the small lesion size and/or difficult anatomic exposure. Identification of such lesions can be facilitated using a hand-held gamma probe with utilization of Tc-99m macroaggregate albumen (MAA) localization technique. The radiopharmaceutical injection can be performed using ultrasound (US) or endoscopy guidance.

Case presentations

The clinical use of the Tc-99m MAA protocol gamma probe-guided surgery was discussed in three representative cases. Surgical indication was diagnostic exploration in two patients with suspicious lymphadenopathy, and determination of extent of surgical resection in a patient with polyposis. Lesion localization with 100 microcurie (3.7 MBq) Tc-99m MAA prior to surgical exploration resulted in definitive localization of lesions intraoperatively.

Conclusion

The use Tc-99m MAA deposition technique at the site of surgical target is a highly efficient radio-guided surgery technique with definitive impact on the success of surgical exploration in selected indications.