[Clinical application of ROLL technique in non-breast diseases. Complementary use after PET-CT study]

Area of Science:

• Nuclear medicine
• Oncology
• Radiology

Background:

• Positron Emission Tomography-Computed Tomography (PET-CT) identifies hypermetabolic lesions, but differentiating malignancy from benign conditions can be challenging.
• Accurate localization is crucial for guiding biopsies and treatment decisions, especially for non-breast lesions.

Purpose of the Study:

• To assess the efficacy of the Radioguided Occult Lesion Localization (ROLL) technique.
• To determine its utility in verifying suspicious non-breast lesions identified by PET-CT.

Main Methods:

• Retrospective evaluation of 9 patients with suspected or diagnosed tumors showing hypermetabolic lymph nodes on (18)F-FDG PET-CT.
• ROLL technique involved ultrasound-guided injection of (99m)Tc-albumin macroaggregates into accessible lesions prior to surgery.
• Surgical localization utilized gamma probe and portable gammacamera.

Main Results:

• Successful surgical localization of radiolabeled lymph nodes in all patients using minimally invasive surgery.
• Histological confirmation of malignancy in five patients (lymphoma, germ cell tumor, neuroendocrine carcinoma).
• Identification of four false-positive PET-CT findings (sarcoidosis, reactive follicular hyperplasia).

Conclusions:

• The ROLL technique is a valuable and straightforward method for investigating suspicious non-breast lesions detected via PET-CT.
• It facilitates accurate diagnosis and helps reduce unnecessary procedures by identifying false positives.