Jung Yuh-S, Kim Seok-Ki, Park Insoo, Ryu Junsun, Kim Seok Won, Lee Chang Yoon, Lee Jia
National Cancer Center, Goyang, Republic of Korea.
National Cancer Center, Goyang, Republic of Korea
Surg Innov. 2014 Dec;21(6):622-9. doi: 10.1177/1553350614524840. Epub 2014 Mar 10.
Precise targeting has played a pivotal role in the success of surgery for recurrent differentiated thyroid cancers (DTCs). To improve on current targeting methods, we developed a novel technique using (99m)Tc-macroaggregated human serum albumin and indocyanine green (TIGMA), with which surgeons effectively target lesions in real time by radiofluorescence dual guidance.
Seven patients with 10 recurrent DTC lesions were retrospectively enrolled in the study. Prior to the operation, we injected TIGMA into the target lesion under the guidance of ultrasonography. Resection was concurrently monitored using a gamma probe and a specially designed near infrared fluorescence camera. Outcomes were evaluated using imaging, surgical, and pathological records.
In all enrolled cases, both injection of TIGMA and radiofluorescence dual guidance were well tolerated and easy to implement. The technical success rates were 100%, confirmed by final pathological examination, postoperative ultrasonography, and I-131 scan clearance. Complications such as temporary postoperative neck pain (n = 2) were minimal.
TIGMA using radiofluorescence dual guidance facilitated the precise targeting of recurrent lesions. The entire procedure was feasible, safe, and successful. This method would help enhance surgical outcomes for recurrent DTCs.
精准定位在复发性分化型甲状腺癌（DTC）手术成功中发挥了关键作用。为改进当前的定位方法，我们开发了一种使用（99m）锝-聚合人血清白蛋白和吲哚菁绿（TIGMA）的新技术，通过该技术外科医生可在放射性荧光双重引导下实时有效地定位病灶。
本研究回顾性纳入了7例有10处复发性DTC病灶的患者。手术前，我们在超声引导下将TIGMA注入目标病灶。同时使用γ探测器和专门设计的近红外荧光相机监测切除情况。通过影像学、手术和病理记录评估结果。
在所有纳入病例中，TIGMA注射和放射性荧光双重引导均耐受性良好且易于实施。经最终病理检查、术后超声检查和I-131扫描清除证实，技术成功率为100%。术后短暂颈部疼痛（n = 2）等并发症极少。
采用放射性荧光双重引导的TIGMA有助于对复发病灶进行精准定位。整个过程可行、安全且成功。该方法将有助于提高复发性DTC的手术效果。
