title: Radioguided exploration facilitates surgical cytoreduction of neuroendocrine tumors.
abstract: BACKGROUND
  Radioguided exploration (RGS) can be an important tool to direct the cytoreduction of neuroendocrine tumors (NETs). The selection of the proper radiolabeled isotope, the dose, and the time interval between isotope injection and exploration are the major factors that lead to the successful use of this technique.
  
  
  METHODS
  Data on 43 patients who underwent RGS of their NET at our facility (Ochsner Medical Center-Kenner) was collected. These cases were reviewed to determine the optimal radiopharmaceutical, dose, and interval between injection and exploration.
  
  
  RESULTS
  The isotopes used were (99)technetium sulfur colloid in three patients, (123)I metaiodobenzylguanidine ((123)I-MIBG) in six patients, and (111)In-pentreotide in 30 abdominal NET patients and in four patients undergoing neck and mediastinum explorations. In 29 of 30 (111)In-pentreotide-guided abdominal explorations (five of which were re-explorations, all successful), the gamma detector was determined to be "helpful". In the four neck and mediastinum explorations, the gamma probe was deemed "essential" for completing a quick, safe, and minimally invasive procedure. (123)I-MIBG injection, in contrast, was useful in only one patient. The optimal dose and interval between injection and exploration of (111)In-pentreotide were discovered to be 6 mCi injected 7 days prior to the planned exploration.
  
  
  CONCLUSIONS
  Radioguided exploration is a useful tool to guide the cytoreduction of NETs. The correct choice of radiopharmaceutical, its dose, and the interval between injection and exploration are critical for obtaining optimal results.
authors: Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA 70012, USA. ywang@lsuhsc.edu
authors: Yi-Zarn
authors: YZ
authors: Wang
authors: Anne
authors: A
authors: Diebold
authors: Eugene
authors: E
authors: Woltering
authors: Heather
authors: H
authors: King
authors: J Philip
authors: JP
authors: Boudreaux
authors: Lowell B
authors: LB
authors: Anthony
authors: Richard
authors: R
authors: Campeau
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D007432:Intraoperative Period; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging / Q000601:surgery*; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016105:Parathyroidectomy / Q000379:methods*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals