Objective. To describe a technique that assists in the surgical management of recurrent local regional well-differentiated thyroid cancer (WDTC). Study Design. Case series with chart review. Setting. Two academic health centers from 2001 to 2009. Subjects and Methods. Patients operated upon by the senior surgeon (BCS) for recurrent WDTC. Results. Thirteen patients with recurrent WDTC were operated upon with radioguided surgical (RGS) technique to indentify recurrence for excision. Eight patients had iodine avid disease and were candidates for RGS with 131I. The remaining 5 patients had cancer with a proven loss of iodine avidity and were, therefore, operated upon with a fluorodeoxygluocose (FDG) RGS technique. Conclusion. RGS is a feasible approach to identify recurrent disease in an operated field and ensure its successful excision. Although focal disease may be identified with this technique, this is not a tool for limited excisions ("berry picking").
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