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Title: Radio-guided occult lesion localisation using iodine 125 Seeds “ROLLIS” to guide surgical removal of an impalpable posterior chest wall melanoma metastasis

Abstract

Cancer screening and surveillance programmes and the use of sophisticated imaging tools such as positron emission tomography-computed tomography (PET-CT) have increased the detection of impalpable lesions requiring imaging guidance for excision. A new technique involves intra-lesional insertion of a low-activity iodine-125 ({sup 125}I) seed and detection of the radioactive signal in theatre using a hand-held gamma probe to guide surgery. Whilst several studies describe using this method to guide the removal of impalpable breast lesions, only a handful of publications report its use to guide excision of lesions outside the breast. We describe a case in which radio-guided occult lesion localisation using an iodine 125 seed was used to guide excision of an impalpable posterior chest wall metastasis detected on PET-CT.

Authors:
 [1];  [2];  [2];  [3];  [3]
  1. Western Hospital, Footscray, Victoria (Australia)
  2. Royal Perth Hospital Perth, Perth, Western Australia (Australia)
  3. (Australia)
Publication Date:
OSTI Identifier:
22420153
Resource Type:
Journal Article
Resource Relation:
Journal Name: Journal of Medical Radiation Sciences (Print); Journal Volume: 62; Journal Issue: 3; Other Information: PMCID: PMC4592678; PMID: 26451246; OAI: oai:pubmedcentral.nih.gov:4592678; Copyright (c) 2015 The Authors. Journal of Medical Radiation Sciences published by Wiley Publishing Asia Pty Ltd on behalf of Australian Institute of Radiography and New Zealand Institute of Medical Radiation Technology.; This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
Australia
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; CHEST; IODINE 125; MAMMARY GLANDS; MELANOMAS; METASTASES; POSITRON COMPUTED TOMOGRAPHY; REMOVAL; SEEDS; SURGERY; WALLS

Citation Formats

Dissanayake, Shashini, Dissanayake, Deepthi, Taylor, Donna B, School of Surgery, University of Western Australia, Crawley, Western Australia, and Western Hospital, Footscray, Victoria. Radio-guided occult lesion localisation using iodine 125 Seeds “ROLLIS” to guide surgical removal of an impalpable posterior chest wall melanoma metastasis. Australia: N. p., 2015. Web. doi:10.1002/JMRS.125.
Dissanayake, Shashini, Dissanayake, Deepthi, Taylor, Donna B, School of Surgery, University of Western Australia, Crawley, Western Australia, & Western Hospital, Footscray, Victoria. Radio-guided occult lesion localisation using iodine 125 Seeds “ROLLIS” to guide surgical removal of an impalpable posterior chest wall melanoma metastasis. Australia. doi:10.1002/JMRS.125.
Dissanayake, Shashini, Dissanayake, Deepthi, Taylor, Donna B, School of Surgery, University of Western Australia, Crawley, Western Australia, and Western Hospital, Footscray, Victoria. Tue . "Radio-guided occult lesion localisation using iodine 125 Seeds “ROLLIS” to guide surgical removal of an impalpable posterior chest wall melanoma metastasis". Australia. doi:10.1002/JMRS.125.
@article{osti_22420153,
title = {Radio-guided occult lesion localisation using iodine 125 Seeds “ROLLIS” to guide surgical removal of an impalpable posterior chest wall melanoma metastasis},
author = {Dissanayake, Shashini and Dissanayake, Deepthi and Taylor, Donna B and School of Surgery, University of Western Australia, Crawley, Western Australia and Western Hospital, Footscray, Victoria},
abstractNote = {Cancer screening and surveillance programmes and the use of sophisticated imaging tools such as positron emission tomography-computed tomography (PET-CT) have increased the detection of impalpable lesions requiring imaging guidance for excision. A new technique involves intra-lesional insertion of a low-activity iodine-125 ({sup 125}I) seed and detection of the radioactive signal in theatre using a hand-held gamma probe to guide surgery. Whilst several studies describe using this method to guide the removal of impalpable breast lesions, only a handful of publications report its use to guide excision of lesions outside the breast. We describe a case in which radio-guided occult lesion localisation using an iodine 125 seed was used to guide excision of an impalpable posterior chest wall metastasis detected on PET-CT.},
doi = {10.1002/JMRS.125},
journal = {Journal of Medical Radiation Sciences (Print)},
number = 3,
volume = 62,
place = {Australia},
year = {Tue Sep 15 00:00:00 EDT 2015},
month = {Tue Sep 15 00:00:00 EDT 2015}
}
  • Ventricular free wall rupture remains the most serious complication after acute myocardial infarction. In early-recognized, subacute cases a surgical intervention using patches can be lifesaving. However, in the rare case of postoperative patch leakage, a relapse of a pseudoaneurysm may occur. This is the first case in the literature-to the best of our knowledge-describing a minimally invasive strategy using CT fluoroscopic guidance to perform an injection of thrombin into the perfused pseudoaneurysm to seal a leakage. This therapeutical regimen was chosen-in accordance with cardiac surgeons, cardiologists, and interventional radiologists-due to the high risk of adverse event after repeated surgery inmore » this particular patient. The follow-up images showed complete occlusion of the pseudoaneurysm after the thrombin injection. This approach could be discussed in a multidisciplinary setting in similar cases, especially due to the described negligible recurrence rate after successful initial thrombosis after treating femoral pseudoaneurysms, pseudoaneurysms of the pancreatic artery, or even endoleaks after stenting of aneurysms of the aorta.« less
  • Twenty-eight cases of posterior choroidal melanoma were treated with iodine-125 in gold eye plaques. Eleven cases were located within 3.0 mm of the optic nerve (group A), nine were within 3.0 mm of the fovea (group B), and eight were within 3.0 mm of the optic nerve and fovea (group C). The mean follow-up of group A was 46.3 months; group B, 25.5 months; and group C, 42.7 months. Complications included macular edema, cataract and tumor growth. Visual acuity remained within two lines of that tested preoperatively for 4 of 11 patients in group A, 4 of 9 in groupmore » B, and 5 of 8 in group C. These results with iodine-125 suggest it as an appropriate treatment for patients with choroidal melanoma located near optic nerve and/or macula.« less
  • Cancer of the pancreas is most often not diagnosed before it has reached unresectable stages. The development of effective palliative treatment for these patients and for those with recurrence after resection is clearly needed. The present study reports the results of ultrasonically guided percutaneous implantation of {sup 125}I seeds in 19 patients with cancer of the pancreas. Twelve patients had further adjuvant external radiation. Despite satisfactory seed placement and delivery of the planned radiation dose in most cases, clinical improvement was lacking or only slight and short-lived. No difference in survival or palliation was observed between patients treated with seedsmore » alone compared with patients treated with seeds and external radiation. Survival after seed implantation was short (median 140 days, range 7-401 days). Ultrasonically guided percutaneous implantation of {sup 125}I seeds cannot be recommended in the treatment of unresectable carcinoma of the pancreas.« less
  • To avoid thoracotomy, we recently placed 70 /sup 125/I seeds percutaneously with the aid of CT guidance for treatment of an unresectable carcinoma of the lung. We achieved a successful distribution of seeds without complications.
  • The dosimetry of ophthalmic plaques designed to hold iridium-192 or iodine-125 seeds is investigated experimentally and by means of a computer model. A phantom for thermoluminescent dosimetry (TLD) which permits measurements to within 2 mm of the plaque surface is described. TLD data are compared with model calculations that take into account the active length of the seeds, anisotropy of dose distribution from single seeds, and scatter within the phantom. An isotropic point source calculational model is accurate for clinical calculations, particularly at depths greater than 5 mm. Relative central axis dose measurements for /sup 125/I in a gold plaquemore » are also in agreement with the model. Comparisons of /sup 192/Ir, /sup 125/I and /sup 60/Co plaques are presented. The relative advantages of using these isotopes in eye plaques are discussed.« less