Tracers Applied in Radioguided Surgery

Abstract

Radioguided surgery (RGS) allows a surgeon to intraoperatively identify the lesions of interest. This technique relies on the accumulation of a radiotracer in the lesion(s) of interest. Such accumulation can occur via the local administration of the radiotracer, followed by local staining or passive drainage via the lymphatic system, or can occur via the systemic administration followed by retention or targeted accumulation of the radiotracer. The range of radiotracers applied in RGS varies from the radioactive isotope itself, to small molecules, peptides, antibodies, and colloids. The choice of the radionuclide depends on various factors, such as half-life, desired radiation type and energy, and (chemical) means to attach it to an active entity. An often overlooked factor is the radiation burden for the patient and the medical personnel. The introduction of optical imaging technologies, such as fluorescence and Cherenkov imaging, expands the utility of RGS.