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Title: Open rib biopsy guided by radionuclide technique

When abnormally increased radioactivity is seen in a rib or ribs by bone imaging in a patient with suspected or known malignancy, it frequently is difficult to differentiate fracture from metastatic disease. Histological examination of the lesion is crucial for diagnosis, staging, and planning of therapy. To assess the value of external localization of the site or sites of abnormal uptake in a rib as a guide for open rib biopsy, 10 patients (7 men, 3 women; age range, 34 to 68 years) with known or suspected malignancy were studied. With reference to the oscilloscope image, a cobalt 57 marker was placed on the skin overlying the focus of increased uptake, and the area of increased activity was marked on the skin as a guide to surgical resection. Of ten resected ribs, four showed metastatic disease and five had fractures. (One patient underwent two external marking procedures and two surgical procedures.) Rib biopsy was not performed in 1 patient because prior to the surgical procedure, a small subcutaneous nodule adjacent to the skin marker was excised and confirmed to be carcinoma. Appropriate courses of management (operation, irradiation, chemotherapy) were taken after the biopsies. The surgeon responsible for the biopsy shouldmore » be present during the skin-marking procedure, and the area beneath the scapula and the region adjacent to the spine should be avoided. Our results indicate that the technique is a very useful aid for approaching open rib biopsies more precisely.« less
Authors:
; ; ; ;
Publication Date:
OSTI Identifier:
6627747
Resource Type:
Journal Article
Resource Relation:
Journal Name: Ann. Thorac. Surg.; (United States); Journal Volume: 38:1
Research Org:
Thoracic Surgery Service, Veterans Administration, Medical Center, Lexington, KY
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BONE TISSUES; BIOPSY; ACCURACY; BONE FRACTURES; CHEST; COBALT 57; DIAGNOSIS; IMAGES; METASTASES; RADIOACTIVITY; ANIMAL TISSUES; BETA DECAY RADIOISOTOPES; BODY; BODY AREAS; COBALT ISOTOPES; CONNECTIVE TISSUE; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; ELECTRON CAPTURE RADIOISOTOPES; INJURIES; INTERMEDIATE MASS NUCLEI; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; RADIOISOTOPES; TISSUES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics