Radioactive iodine-125 seed localization as an aid in reoperative neck surgery

Am J Surg. 2021 Mar;221(3):534-537. doi: 10.1016/j.amjsurg.2020.12.048. Epub 2021 Jan 11.

Abstract

Background: Scarring and disrupted tissue planes add to already-complex neck anatomy and make localization of nonpalpable pathology difficult in cervical endocrine reoperations. We describe the use of radioactive iodine-125 seed localization (RSL) in 6 patients with metastatic papillary thyroid carcinoma (PTC) and 2 with recurrent hyperparathyroidism.

Methods: Eight patients had 2-D ultrasound-guided RSL of the target lesion, 0-3 days preoperatively. Intraoperative gamma probe (Neoprobe) was used to plan incision placement and localize the implanted seed. Recorded operative variables included: number of lymph nodes (LNs) harvested, estimated blood loss (EBL), operative time, length of stay (LOS) and RSL and operative complications.

Results: All patients had successful resection of the targeted area and removal of the radioactive seed. There was no seed migration. Two complications occurred in the thyroid group.

Conclusion: Radioactive iodine 125 seeds facilitate successful localization of endocrine pathology during reoperative cervical procedures.

Keywords: Cervical; Endocrine; Localization; Radioactive; Reoperative; Seed.

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Iodine Radioisotopes*
  • Male
  • Middle Aged
  • Neck Dissection*
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / surgery*
  • Reoperation
  • Thyroid Cancer, Papillary / diagnostic imaging
  • Thyroid Cancer, Papillary / surgery*
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy*

Substances

  • Iodine Radioisotopes
  • Iodine-125