Computed tomography-guided preoperative localization of musculoskeletal lesions using the ROLL technique

OBJECTIVE: To describe the preoperative localization of musculoskeletal lesions with the radioguided occult lesion localization (ROLL) technique. MATERIALS AND METHODS: In all cases, computed tomography-guided injection of technetium-99m sulfur colloid was performed, directly into or near the suspicious lesion, up to 36 hours before the surgical procedure. Lesions were detected intraoperatively with a gamma probe. RESULTS: We report the cases of six patients submitted to radioguided surgery, including three patients with bone lesions suspicious for metastasis, two patients suspected of recurrent sarcoma, and one patient with no previous diagnosis who had a nodular lesion on the left leg. Patients tolerated the procedure well, and no complications were associated with the puncture. All marked lesions were easily identified intraoperatively and were excised with clear margins. CONCLUSION: The ROLL technique was effective in the intraoperative localization of occult musculoskeletal lesions, demonstrating that it is a feasible and promising technique for the surgical exploration of selected cases.