title: A multimodality localization technique for radio-guided surgery.
abstract: BACKGROUND
  Intraoperative localization of image or endoscopy-detected lesions occasionally pose surgical challenges due to the small lesion size and/or difficult anatomic exposure. Identification of such lesions can be facilitated using a hand-held gamma probe with utilization of Tc-99m macroaggregate albumen (MAA) localization technique. The radiopharmaceutical injection can be performed using ultrasound (US) or endoscopy guidance.
  
  
  METHODS
  The clinical use of the Tc-99m MAA protocol gamma probe-guided surgery was discussed in three representative cases. Surgical indication was diagnostic exploration in two patients with suspicious lymphadenopathy, and determination of extent of surgical resection in a patient with polyposis. Lesion localization with 100 microcurie (3.7 MBq) Tc-99m MAA prior to surgical exploration resulted in definitive localization of lesions intraoperatively.
  
  
  CONCLUSIONS
  The use Tc-99m MAA deposition technique at the site of surgical target is a highly efficient radio-guided surgery technique with definitive impact on the success of surgical exploration in selected indications.
authors: Goshen cancer Institute at Goshen Health System, Goshen, IN, USA. sgulec@goshenhealth.com
authors: Seza A
authors: SA
authors: Gulec
authors: Erica
authors: E
authors: Hoenie
authors: Kristan
authors: K
authors: Rheinheimer
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016634:Radiosurgery / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin
chemical_list: D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin