08:58pm Friday 22 September 2017

Radio-guided surgery a safe and simple way to remove potentially cancerous nodules in the lung

Using tiny spheres of radioactive liquid to guide surgeons as they remove potentially cancerous material in the lungs is safe and more effective than other techniques, Italian researchers report at the European Multidisciplinary Conference in Thoracic Oncology (EMCTO), 24-26 February 2011, Lugano, Switzerland.

Dr Luca Bertolaccini, Dr Alberto Terzi and colleagues from Santa Croce e Carle Hospital in Cuneo, Italy, studied a technique known as radio-guided surgery in 19 patients. Each of the patients had been found to have ‘single pulmonary nodules’ in their lungs.

Single pulmonary nodules are solitary abnormalities in the lungs that are smaller than 3 cm in diameter. Improvements in scanning techniques such as computed tomography mean that these very small nodules are becoming more commonly found.

If such nodules are found to be malignant, then surgical treatment to remove them should be undertaken immediately, Dr Bertolaccini said. “The problem is that such lesions are usually peripheral, making bronchoscopic approaches to diagnosis unsuccessful, while the accuracy of CT-guided biopsy is hindered by the small diameter and by the patient’s respiratory movements during the exam.”

“Video-assisted thoracoscopic surgery (VATS) is nowadays the procedure of choice if we want to surgically biopsy and remove peripheral lung nodules. However, the use of VATS is limited by the difficulty in localizing small, deep, or non-solid lung nodules where direct finger palpation may not be possible during surgery.”

Using radio-guided surgery appears to overcome these problems, the researchers found. First they inserted a needle into the lung to reach the lesion or the lung tissue surrounding it. A CT scan carried out while the needle was in place confirmed its exact position.

Next, they injected a solution of 0.3 ml of microspheres of human albumin serum labeled with Technetium

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