Fig. 2

A 72-year-old female with high-grade serous ovarian carcinoma. Six years after surgical resection and chemotherapy, rising serum CA-125 prompted a F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) exam. Coronal fusion FDG PET/CT (a) depicts a hypermetabolic lymph node in her mesentery (red arrow) that was suspicious as a solitary site for metastatic disease. Given concern for difficulty palpating this node intraoperatively, radiolocalization was performed. Using CT guidance (b), a compression device with hollow center displaces overlying bowel as the Tc-99m MAA injection needle (white arrow) is advanced to the target lymph node for perilesional injection. Excellent localization was confirmed by anterior pelvic scintigram (c). This lymph node was surgically removed and confirmed metastatic disease, prompting initiation of chemotherapy