Table 1

Gamma probe-guided surgery protocol for Tc-99m MAA

Tc-99m MAA Lesion Localization with image/endoscopy guidance

Radiopharmaceutical Dose/Administration
• Tc-99m MAA
• 0.1 mCi (.0037 MBq)/direct injection
Standard Imaging Protocol
• No nuclear medicine imaging needed
Timing of Surgical Exploration
• Within 6 h post-injection
Patient Preparation
• Not required
Gamma Probe
• Standard medium-energy gamma probe
System set-up
• Analyzer Settings: Photopeak: 140 keV, Window: 20%, Threshold: 136 keV (In commercial systems this is a default setting)
• Verify calibration and settings of the system
• Cover the probe with sterile plastic sleeve
Intra-operative Use
• Probe survey at counts- per-second mode (Dynamic pitch range feed-back helpful)
• Hot-spot confirmation with TBR>1.5 at 10-second count mode (TBR ratio feed-back helpful)
Avoid simultaneous electrocautery use

Gulec et al. World Journal of Surgical Oncology 2007 5:43   doi:10.1186/1477-7819-5-43