Target-specific rib biopsy using the gamma probe

Background: Intraoperative localization of rib abnormalities identified on bone scan can be deceptively difficult. Previously used techniques have had limited sensitivity and accuracy. The gamma probe can help localize these bone scan “hot spots.” Methods: Over the past 17 months, 5 patients underwent gamma-probe–directed limited rib resections following intravenous administration of Tc99m-MDP. Three patients required biopsies for suspected malignancy, and the other 2 underwent therapeutic resections for pain. The device was easy to work with following minimal training. Results: Localization was excellent, limiting the extent of surgery needed. Comparison with rib counting and preoperative bone scan localization showed a discrepancy of up to 13 cm. Sensitivity and accuracy were each 100%. Conclusions: The gamma probe offers a simple and significant advance in the performance of rib biopsies for nonpalpable lesions.