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Radioguided Occult Lesion Localization: Technical Procedures and Clinical Applications
Gianpiero Manca1, Sara Mazzarri, Domenico Rubello
1From the *Regional Center of Nuclear Medicine, Hospital University of Pisa, Pisa; †Department of Nuclear Medicine, Radiology and Clinical Pathology, "S. Maria della Misericordia" Hospital, Rovigo, Italy; ‡Servicio de Medicina Nuclear, Hospital Clínico San Carlos, Madrid, Spain; §Unit of Senology Hospital University of Pisa, Pisa, Italy; ∥Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria; and ¶Department of Radiology, University of Southern California, Los Angeles, CA.
Radioguided occult lesion localization (ROLL) uses imaging and intraoperative detection for occult tumors. This technique has evolved into Guided intraOperative Scintigraphic Tumor Targeting (GOSTT), incorporating advanced tracers and navigation for improved surgical guidance.
Area of Science:
- Oncology
- Radiology
- Surgical Innovation
Background:
- Radioguided surgery enhances tumor localization.
- Occult neoplastic lesions pose diagnostic and surgical challenges.
Purpose of the Study:
- To describe radioguided occult lesion localization (ROLL) and its evolution.
- To introduce the concept of Guided intraOperative Scintigraphic Tumor Targeting (GOSTT).
Main Methods:
- Preoperative imaging and intraoperative radioguided detection of occult lesions.
- Direct administration of Tc-macroaggregated human albumin into the lesion for biopsy guidance.
- Expansion of ROLL to various tumors beyond breast lesions.
Main Results:
- ROLL is effective for nonpalpable breast lesions, solitary pulmonary nodules, and thyroid carcinoma recurrences.
- The GOSTT concept was developed to encompass a broader range of radioguided procedures.
- GOSTT provides a comprehensive "road map" for surgeons.
Conclusions:
- ROLL and GOSTT have advanced with hybrid tracers for dual-signal detection.
- Innovative navigation systems utilizing mixed-reality protocols are being integrated.
- These advancements aim to further refine radioguided surgical techniques.