Patient Selection Rather Than Detection Alone: Defining the Surgical Value of Radioguided Surgery in Neuroendocrine Tumors

Radioguided surgery has emerged as a useful adjunct for the intraoperative localization of neuroendocrine tumors, particularly when lesions are small, occult, recurrent, or difficult to identify using conventional imaging and standard surgical inspection. A recent case series by Uña-Gorospe et al. highlighted the feasibility of somatostatin receptor–based radioguided surgery for identifying neuroendocrine tumor lesions during operative exploration. While the technical value of gamma probe guidance is clearly demonstrated, its broader surgical relevance depends on more precise patient selection and whether intraoperative radiotracer findings lead to a meaningful change in surgical management. From a surgical oncology perspective, the main question is not only whether radioguided surgery can detect additional lesions but also whether this detection alters the operative strategy, extent of resection, lymph node dissection, margin assessment, or confirmation of tumor-bed clearance. Clarifying these aspects would help define radioguided surgery as a decision-changing surgical adjunct rather than a purely localization-based technique. This letter emphasizes the importance of reporting patient selection criteria and the impact of intraoperative decisions when evaluating radioguided surgery for neuroendocrine tumors.

کلیدواژه ها:

Somatostatin receptor imaging ، Gamma probe ، Intraoperative localization ، Operative decision-making ، Margin assessment