title: Is there a role for radioguided surgery with iodine-labeled metaiodobenzylguanidine in resection of neuroendocrine tumors?
abstract: OBJECTIVE
  The aim of this study was to systematically review literature, exploring the role of radioguided surgery with iodine-labeled metaiodobenzylguanidine (MIBG) in resection of neuroendocrine tumors.
  
  
  METHODS
  PubMed, EMBASE, Web of Science, COCHRANE, CINAHL, Academic Search Premier, ScienceDirect, Wiley, and references of key articles were searched to identify potentially relevant studies.
  
  
  RESULTS
  Twenty studies were included. A total of 130 procedures in 120 patients were performed. Ninety percent of included studies concerned case reports or case series. It is described that radioguided surgery with iodine-labeled MIBG can improve the quality of macroscopic resection of neuroendocrine tumors in selected cases, ie, in cases where the tumor is small, nonpalpable, difficult to visualize on conventional imaging studies, or located in an area with adhesional scar tissue from previous surgery. However, in a substantial number of cases the gamma probe failed due to technical problems.
  
  
  CONCLUSIONS
  Since there is limited evidence that radioguided surgery contributes substantially in resection of neuroendocrine tumors, we cannot advocate its use in general. However, we can conclude that it can seemingly improve the quality of resection in selected cases. When radioguided surgery is performed in neuroendocrine tumors, we advocate the use of I to label MIBG.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, Leiden, The Netherlands. L.T.van_Hulsteijn@lumc.nl
authors.forename: Leonie T
authors.initials: LT
authors.lastname: van Hulsteijn
authors.forename: Eleonora P M
authors.initials: EP
authors.lastname: Corssmit
authors.forename: Bernies
authors.initials: B
authors.lastname: van der Hiel
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Stokkel
mesh_terms: D019797:3-Iodobenzylguanidine; D006801:Humans; D007457:Iodine Radioisotopes; D018358:Neuroendocrine Tumors / Q000000981:diagnostic imaging* / Q000601:surgery*; D011877:Radionuclide Imaging; D016634:Radiosurgery / Q000379:methods*; D013194:Staining and Labeling
chemical_list: D007457:Iodine Radioisotopes; D019797:3-Iodobenzylguanidine