Didactic review of 175 radionuclide-guided excisions of osteoid osteomas

The complete removal of a lesion which resembles, or is covered by adjacent tissue may be difficult. Therefore, the capacity of certain lesions to specifically concentrate a radiopharmaceutical has been used to orient progress during surgery. Usually, the measurements of radioactivity in the operative field are carried out by means of small, handy radiation-detecting probes which can be sterilized. Intra-operative nuclear medicine or radionuclide-guided surgery has steadily gained in importance. However, this technique is not being taught. Our study, based on radionuclide-guided surgery of 175 orthopaedic patients suspected of having osteoid osteoma, is well suited to teach the particularities of intra-operative radiation detection, as well as the collaboration between the nuclear physician and the surgeon in the operating theatre.Part of this work was carried out when M.W. and A. S.-A. were at the Saint-Antoine (Paris) and Henri Mondor (Créteil) hospitals respectively.