Radioguided occult colonic lesion identification (ROCLI) during open and laparoscopic surgery

Area of Science:

• Gastroenterology
• Surgical Oncology
• Nuclear Medicine

Background:

• Intraoperative localization of small, nonpalpable colonic lesions can be challenging, especially with concurrent inflammatory bowel conditions.
• Peculiar lesion locations and associated inflammation complicate surgical identification.

Purpose of the Study:

• To evaluate the efficacy of radioguided identification following preoperative labeling for colonic lesions.
• To assess the validity of using a gamma probe for intraoperative localization.

Main Methods:

• Patients with difficult-to-detect colonic lesions underwent colonoscopy 1-2.5 hours pre-surgery.
• A subserosal injection of 99mTc-labeled albumin macroaggregates was administered near the lesion.
• A gamma detecting probe was used for transcutaneous lesion identification during surgery (open or laparoscopic).

Main Results:

• 15 colonic lesions in 14 patients were successfully localized using the radioguided technique.
• The method demonstrated high accuracy, speed, and cost-effectiveness.
• No intraoperative complications or patient irradiation occurred.

Conclusions:

• Preoperative endoscopic marking with 99mTc-labeled albumin macroaggregates is a valuable clinical method.
• Intraoperative detection using a gamma probe provides accurate and safe localization of nonpalpable colon lesions.
• This technique is highly accurate, complication-free, and suitable for various surgical approaches.