Radio-guided surgery of differentiated thyroid cancer using 131I or 99mTc-Sestamibi

Domenico Rubello, Massimo Salvatori, Maria Rosa Pelizzo, Lucia Rampin, Stefano Fanti, Michele Gregianin, Giuliano Mariani

Research output: Contribution to journalArticlepeer-review


The classical therapeutic approach to patients with differentiated thyroid cancer (DTC) is based on total or near-total thyroidectomy, followed by I treatment and thyroid-stimulating hormone suppressive therapy. This approach allows complete cure in many patients, especially when the tumour is diagnosed at an early stage; it also allows long-term survival in patients with locoregional recurrences or distant metastases if they can be treated with I. In contrast, when metastatic DTC deposits lose their ability to trap I (non-functioning metastases), a worse prognosis is expected. Nevertheless, in patients with locoregional non-functioning recurrences, an early diagnosis and prompt surgical extirpation can lead to a favourable prognosis. In these cases, radical surgery is needed. This can be achieved with radio-guided surgery using a hand-held gamma probe and a tumour-seeking radiotracer to detect, intraoperatively, the smallest metastatic lesions. In this paper, we discuss the two principal techniques proposed in the literature for radio-guided surgery of non-functioning DTC metastatic recurrences, the first using high doses of I and the second using low doses of Tc-Sestamibi.

Original languageEnglish
Pages (from-to)1-4
Number of pages4
JournalNuclear Medicine Communications
Issue number1
Publication statusPublished - Jan 2006


  • I
  • Tc-Sestamibi
  • Differentiated thyroid cancer
  • Radio-guided surgery

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology


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