Gulec Seza A, Hoenie Erica, Rheinheimer Kristan
Goshen cancer Institute at Goshen Health System, Goshen, IN, USA.
World J Surg Oncol. 2007 Apr 25;5:43. doi: 10.1186/1477-7819-5-43.
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.
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.
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.
由于病变尺寸小和/或解剖暴露困难，图像或内镜检测到的病变的术中定位偶尔会带来手术挑战。使用手持式γ探测器并利用锝-99m聚合白蛋白（MAA）定位技术有助于识别此类病变。放射性药物注射可在超声（US）或内镜引导下进行。
在三个典型病例中讨论了锝-99m MAA方案γ探测器引导手术的临床应用。手术指征为对两名可疑淋巴结病患者进行诊断性探查，以及对一名息肉病患者确定手术切除范围。在手术探查前用100微居里（3.7 MBq）锝-99m MAA进行病变定位，从而在术中明确了病变的位置。
在手术靶点部位使用锝-99m MAA沉积技术是一种高效的放射性引导手术技术，对选定指征下手术探查的成功具有决定性影响。
