Radionuclide Localization > Advantages

Advantages

1. Because no needle is left in place, dislodgement during transport from the radiology department to the operating suite is not a concern.

2. Tc-99m MAA is relatively inexpensive and readily available in any radiology department providing nuclear medicine services.

3. Because Tc-99m MAA is routinely injected intravascularly to perform lung perfusion scans, inadvertent radiotracer embolization would be associated with negligible morbidity.

4. The procedure for Tc-99m MAA placement requires a radiologist proficient in CT-guided biopsies, a skill that is readily available at most institutions.

5. The injection requires much less of a radiologist's time than attempts to aspirate a tissue sample from these small lung nodules.

6. The procedure does not require intraoperative fluoroscopy but rather can be done with a handheld gamma probe available in any operating unit that performs sentinel node surgery. Minimal additional surgeon training is required for using the handheld radioprobe intraoperatively.

7. Frozen and permanent pathologic examination of the specimen is not affected by the localization technique.

8. There is no significant risk to operating room and pathology department personnel from the low-dose gamma radiation.

9. Our laboratory studies suggested (and our subsequent clinical experience has confirmed) that Tc-99m MAA produces a small intraparenchymal injection site that maximizes accuracy of lung nodule localization while minimizing the amount of tissue removed.

10. Our animal data and clinical experience have demonstrated that Tc-99m MAA is quite stable and focally maintained in the lung for up to 8 hours, providing a reasonable and somewhat flexible window of time between injection and thoracoscopic excision.

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