Análisis multidisciplinario con ecografía y SPECT-CT (AMESPECT), previo a cirugía radioguiada (CRG) por lesión local recurrente de tiroides (LLRCT): ¿Mejora el propio acto quirúrgico versus una CRG convencional?


The first treatment option for LLRCT (local recurrent lesions from thyroid carcinoma) is surgical. However, there are logistic and "language" difficulties when the surgeon integrates the information from imaging studies to plan re-intervention, decrease morbidity, and obtain good results. In turn, the CRG (radioguided surgery) contributes to increase the surgical effectiveness in these cases. This work describes a multidisciplinary approach carried out by specialists in nuclear medicine, radiology and head and neck surgery, integrating clinical data, previous images, ultrasound of radiolabeled lesion and data generated by the SPECT-CT (AMESPECT), in 17 patients taken to CRG by LLRCT with several previous interventions. Using this approach, the operative act was 100% effective without increasing the surgical or hospital times, or the complexity or surgical morbidity. It should be noted that in 65% of cases the surgical plan had to be modified since there was an increase in sensitivity for the detection of other LLRCT apart from the radiolabeled ones.