Target-specific rib biopsy using the gamma probe

Fernandes, Darryl S; Aye, Ralph W.; Garnett, Daniel J; J, Denny

doi:10.1016/s0002-9610(00)00364-0

Cited by 10 publications

(4 citation statements)

References 13 publications

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“…Within the last few years, other centers have also reported Tc-99m-guided rib resection. 1,10 The major advantage of this innovative method is its increased success in detecting scintigraphically positive but nonpalpable lesions with up to 100% sensitivity and accuracy 1,10 -12 This method allows accurate localization, optimal incision placement, and limited tissue and bone removal. Ultimately, this should lead to better results in terms of quality of life, postoperative pain, recovery time, and cosmesis.…”

Section: Discussionmentioning

confidence: 99%

“…In a situation where lesions are not palpable, difficulty in identification may lead to a larger incision and resection of more rib than is necessary. Methods that have been used to aid in the localization of rib lesions include rib counting, 1 preoperative marking of the skin overlying the lesion, 2 wire-guided biopsies, 3 image-guided percutaneous biopsies, 4 preoperative methylene blue staining, 5 and serial x-ray films or scintigraphy with radiopaque markers. 6 The Navigator probe is a hand-held gamma counter (C-Trak Automatic, Carewise Medical Products Corp, Morgan Hill, CA) ( Fig.…”

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confidence: 99%

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Use of the Navigator Probe after Radiotracer Injection to Identify Nonpalpable Rib Lesions Requiring Surgical Resection

Erdem

Daly

Stone³

et al. 2006

Innovations�(Phila)

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Background Patients with nonpalpable rib lesions (NPRL) requiring biopsy present a challenging problem for the thoracic surgeon. Ideally, a small incision directly over the NPRL should be performed to minimize morbidity, particularly if the lesion is benign. The Navigator probe is routinely used after lymphoscintigraphy by surgical oncologists to isolate sentinel lymph nodes requiring removal, but can also be used to guide resection of nonpalpable focal rib lesions demonstrating increased technetium-99m hydroxymethylene diphosphonate (Tc-99m HDP) uptake. This report describes our initial experience with this technique. Methods Over a 5-month period, 3 patients with focal NPRL underwent rib resection. All patients had solitary lesions demonstrated on recently performed Tc-99m HDP bone scanning. Prior cancers were reported in 2 patients, and pain in 2 patients. Before surgery, all patients underwent intravenous injection of 20 to 25 mCi Tc-99m HDP at least 2 hours before the Navigator probe-guided procedure. Results The Navigator probe identified all 3 lesions, allowing a single 4 cm or smaller incision in all cases. Histology included metastatic breast cancer (1), pathologic fracture secondary to metastatic palatal cancer (1), and eosinophilic granuloma (1). No patient required further resection. Conclusions Intraoperative localization of NPRL that are positive on Tc-99m HDP bone scanning using the Navigator probe is feasible and was 100% successful in our initial experience. This technique allows a minimally invasive approach, which is beneficial for those patients who do not require further resection.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Use of the Navigator Probe after Radiotracer Injection to Identify Nonpalpable Rib Lesions Requiring Surgical Resection

Erdem

Daly

Stone³

et al. 2006

Innovations�(Phila)

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“…Radioisotope-guided localization and resection of non-palpable focal lesion of the rib misleading due to the remarkable shifting of skin and soft tissues in relation to bone that occurs during repositioning for surgical exposure. This may culminate in misleading results, in particular in the chest wall where consistent shifting frequently occurs due to repositioning of the patient and of the arms; moreover, rib counting, wires or methylene blue staining may be inaccurate in obese or very muscular patients (8,9,(11)(12)(13). Thanks to recent advancements, many focal rib lesions can be preoperatively detected by CT and PET (14); nevertheless, it can be difficult to correctly localize target lesions for its biopsy, in particular in case of non-palpable lesion; moreover, it is of paramount importance an adequate preoperative marking for an optimal patient positioning and to select the most appropriate surgical access.…”

Section: Surgical Techniquementioning

confidence: 99%

Radioisotope-guided localization and resection of non-palpable focal lesion of the rib

Petrella¹,

Iacono²,

Casiraghi³

et al. 2020

J Thorac Dis

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“…Afterwards, a simple technique for localization of bone metastases guided by the gamma probe intraoperatively was described (4). The technique has been used to obtain biopsies from the ribs, sternum, pubis and cranium (1,3,(5)(6)(7)(8). Reports on the technique, which deserves widespread attention, originate from three American centres and are published in American literature exclusively.…”

Section: Introductionmentioning

confidence: 99%

Radioisotope-Guided Surgical Biopsy of Costal Metastases in Breast Cancer Patients

Axelsson¹,

Nielsen²,

Graff

2002

Scand J Surg

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Radioisotope bone scanning is a sensitive indicator of metastatic disease. Localization of the hot spot for biopsy is difficult. Today, a hand-held gamma probe enables the surgeon intraoperatively to accomplish the localization procedure easily. As this technique is described in American literature exclusively, more recent European findings is presented here. During one month two patients were diagnosed with breast cancer. Bone scanning disclosed minor hot spots in the ribs. On the day of surgical biopsy the localization of the hot spots was guided by a gamma probe. For the biopsy a dermal punch biopsy needle was employed, and fine needle aspiration biopsies were also taken. The procedures were easy and completed within a few minutes. The post-operative courses were uneventful. In one patient, final histology showed malignancy in both biopsies. In the other patient, only the fine needle aspiration biopsy was malignant. The punch biopsy was abnormal, but did not contain malignant tissue. The gamma probe is an important tool in the performance of rib biopsies of nonpalpable lesions. The punch biopsy technique is simple and combined with fine needle aspiration biopsy the method has proven to be sensitive and accurate. The punch biopsy technique furthermore reduces the risk of postoperative pneumothorax.

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Target-specific rib biopsy using the gamma probe

Cited by 10 publications

References 13 publications

Use of the Navigator Probe after Radiotracer Injection to Identify Nonpalpable Rib Lesions Requiring Surgical Resection

Use of the Navigator Probe after Radiotracer Injection to Identify Nonpalpable Rib Lesions Requiring Surgical Resection

Radioisotope-guided localization and resection of non-palpable focal lesion of the rib

Radioisotope-Guided Surgical Biopsy of Costal Metastases in Breast Cancer Patients

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