Intraoperative radiation exposure with the use of 18F-FDG-guided thyroid cancer surgery

Radio-guided surgery is an established means for surgeons to identify a target of interest for biopsy or excision. This technique is used for a variety of malignancies as well as minimally invasive parathyroid surgery. The primary radionuclide used for these procedures is technetium-99m (Tc-99m), but others have been used. Use of (18)fluorine-fluorodeoxyglucose (F-18-FDG) in oncology has proliferated. This has created the opportunity to use F-18-FDG as a potential radio tracer in the operating room. A pilot study of three patients with non-iodine avid thyroid cancers undergoing F-18-FDG guided revision thyroid cancer surgery is reported. Radiation exposure to operating room personnel was measured. Radiation exposure to the surgeon and staff members of an operating room is well below the limits of the National Regulatory Commission. Therefore, utilization of this radiopharmaceutical intra-operatively should not be limited in the future because of concern regarding exposure of operating room personnel to radiation. (C) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.