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

February 26, 2011

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 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 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 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󈟏m (99mTc), an element that is often used for medical tests. After injection, they used another CT scan and a technique called gamma scintigraphy --which visualizes the gamma radiation being emitted by the radioactive isotope-- to confirm precise staining of the nodule.

During surgery to remove the nodule, the researchers used a gamma detector probe to ensure they had removed all the radio-labeled tissue.

The researchers found that the technique was able to localize nodules in all 19 patients. On average it took 6 minutes to detect the nodule with the gamma probe.

Further analysis of the tissue that had been removed showed that it was a primary lung cancer in 8 cases, and a secondary lesion in 4 cases. The remaining 7 patients were found to have benign nodules. There were no complications during or after surgery.

This study shows that radio-guided surgery is a safe and simple technique for localizing single pulmonary nodules, Dr Terzi said. "Radio-guided thoracoscopy seems to be an effective procedure with fewer complications and failures than other techniques."

Commenting on the study, Dr Eric Lim, Consultant Thoracic Surgeon, Royal Brompton Hospital and Senior Lecturer, National Heart and Lung Institute, Imperial College, London, who was not involved in the study, said: "Dr Bertolaccini reports an innovative method to localize nodules that can be difficult for the surgeon to identify during routine surgery."

"This technology supports the current practice of video-assisted thoracoscopic lung resection as surgeons continuously strive to reduce incision size, pain and length of stay to increase the acceptability of surgery for cancer," said Dr Lim.

Related Stories

Recommended for you

Vitamin C may encourage blood cancer stem cells to die

August 17, 2017
Vitamin C may "tell" faulty stem cells in the bone marrow to mature and die normally, instead of multiplying to cause blood cancers. This is the finding of a study led by researchers from Perlmutter Cancer Center at NYU Langone ...

Outdoor light at night linked with increased breast cancer risk in women

August 17, 2017
Women who live in areas with higher levels of outdoor light at night may be at higher risk for breast cancer than those living in areas with lower levels, according to a large long-term study from Harvard T.H. Chan School ...

Scientists develop novel immunotherapy technology for prostate cancer

August 17, 2017
A study led by scientists at The Wistar Institute describes a novel immunotherapeutic strategy for the treatment of cancer based on the use of synthetic DNA to directly encode protective antibodies against a cancer specific ...

Scientists develop blood test that spots tumor-derived DNA in people with early-stage cancers

August 16, 2017
In a bid to detect cancers early and in a noninvasive way, scientists at the Johns Hopkins Kimmel Cancer Center report they have developed a test that spots tiny amounts of cancer-specific DNA in blood and have used it to ...

Toxic formaldehyde is produced inside our own cells, scientists discover

August 16, 2017
New research has revealed that some of the toxin formaldehyde in our bodies does not come from our environment - it is a by-product of an essential reaction inside our own cells. This could provide new targets for developing ...

Cell cycle-blocking drugs can shrink tumors by enlisting immune system in attack on cancer

August 16, 2017
In the brief time that drugs known as CDK4/6 inhibitors have been approved for the treatment of metastatic breast cancer, doctors have made a startling observation: in certain patients, the drugs—designed to halt cancer ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.