A comprehensive overview of radioguided surgery using gamma detection probe technology.

The concept of radioguided surgery, which was first developed some 60 years ago, involves the use of a radiation detection probe system for the intraoperative detection of radionuclides. The use of gamma detection probe technology in radioguided surgery has tremendously expanded and has evolved into what is now considered an established discipline within the practice of surgery, revolutionizing the surgical management of many malignancies, including breast cancer, melanoma, and colorectal cancer, as well as the surgical management of parathyroid disease. The impact of radioguided surgery on the surgical management of cancer patients includes providing vital and real-time information to the surgeon regarding the location and extent of disease, as well as regarding the assessment of surgical resection margins. Additionally, it has allowed the surgeon to minimize the surgical invasiveness of many diagnostic and therapeutic procedures, while still maintaining maximum benefit to the cancer patient. In the current review, we have attempted to comprehensively evaluate the history, technical aspects, and clinical applications of radioguided surgery using gamma detection probe technology.

Anaplastic thyroid cancer.

Anaplastic thyroid cancer is an uncommon, typically lethal malignancy of older adults with no effective systemic therapy. The mean survival time is usually less than 6 months from the time of diagnosis and, unfortunately, this outcome is not fundamentally altered by available treatments. Histologic tissue confirmation is recommended if the diagnosis is not absolutely certain to exclude tumors with better prognosis or that require different treatment. Patency of the airway should be kept in mind throughout the patient's course and individuals with impending airway obstruction, in the absence of imminent death from other sites of disease, should be considered for a tracheostomy to secure the airway. Enrollment in meaningful clinical trials should be given the highest priority at all decision points.