BACKGROUND/MATERIAL AND METHODS: The aim of this study was to assess the reliability of radioiodine ((131)I) and a gamma probe for radio-guided surgery (RGS) to detect and radically dissect lymph node recurrence (LNR) in 15 patients with differentiated thyroid cancer (DTC). The major inclusion criterion was the presence of a radioiodine-positive LNR after previous total thyroidectomy and at least two ineffective (131)I treatments. The protocol was designed as follows: Day 0--all patients were hospitalized and received 3.7 GBq of (131) I while clinically hypothyroid. Day 3--pre-surgery whole-body scan with a therapeutic (131)I dose (TxWBS) was acquired. Day 5--neck surgery using a gamma probe (Navigator GPS, AutoSuture, Italy), recording the absolute counts and the lesion/background (L/B) counts ratio was performed. Day 7--post-surgery TxWBS was performed using the remaining radioactivity. RESULTS AND CONCLUSIONS: This protocol permitted us to identify neoplastic foci with high sensitivity and specificity, enabling us to remove lymph node metastases resistant to radioiodine therapy in a single session. The protocol also allowed detection of some additional tumoural foci in sclerotic areas or behind vascular structures that were not seen at the pre-surgery TxWBS evaluation.
Treatment of local and regional recurrences of differntiated thyroid cancer by radio-guided surgery with iodine-131
PELIZZO, MARIA ROSA;
2006
Abstract
BACKGROUND/MATERIAL AND METHODS: The aim of this study was to assess the reliability of radioiodine ((131)I) and a gamma probe for radio-guided surgery (RGS) to detect and radically dissect lymph node recurrence (LNR) in 15 patients with differentiated thyroid cancer (DTC). The major inclusion criterion was the presence of a radioiodine-positive LNR after previous total thyroidectomy and at least two ineffective (131)I treatments. The protocol was designed as follows: Day 0--all patients were hospitalized and received 3.7 GBq of (131) I while clinically hypothyroid. Day 3--pre-surgery whole-body scan with a therapeutic (131)I dose (TxWBS) was acquired. Day 5--neck surgery using a gamma probe (Navigator GPS, AutoSuture, Italy), recording the absolute counts and the lesion/background (L/B) counts ratio was performed. Day 7--post-surgery TxWBS was performed using the remaining radioactivity. RESULTS AND CONCLUSIONS: This protocol permitted us to identify neoplastic foci with high sensitivity and specificity, enabling us to remove lymph node metastases resistant to radioiodine therapy in a single session. The protocol also allowed detection of some additional tumoural foci in sclerotic areas or behind vascular structures that were not seen at the pre-surgery TxWBS evaluation.Pubblicazioni consigliate
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