Author(s): Grotz Travis E
Introduction There is an increasing use of advanced radiologic imaging for staging and surveillance of solid malignancies resulting in the identification of subclinical non-palpable metastases. Radioactive seed localization (RSL) is a safe and accurate method of localization of non-palpable breast cancers. The aim of this study was to evaluate the expansion of RSL to non-breast lesions. Methods We conducted a retrospective review of a prospective database of all RSL procedures performed at our institution from January 2007 to April 2010. All RSL performed for breast lesions were excluded. Results Eight patients underwent radiologic placement of a 125I seed using ultrasound or computed tomography (CT) guidance. Sites included the upper leg and shoulder, as well as, the internal mammary, infraclavicular and axillary lymph nodes. The mean size of the resected specimen was 2.74 cm in greatest dimension (range 0.6-7.1 cm). The surgeon used a handheld gamma probe for guidance to excise the seed and lesion with negative margins and minimal morbidity. Conclusions RSL is a safe, accurate, and effective technique for the localization and excision of non-palpable non-breast lesions. RSL has the potential to be adapted to many lesions amenable to a percutaneous approach as it permits convenient and accessible localization of the lesion via gamma probe, avoids the issues of wire management with wire localization, and maintains radiation safety through low radioactive seed doses.