RT Journal Article
SR Electronic
T1 Recent developments in Beta Radio Guided Surgery
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 333
OP 333
VO 61
IS supplement 1
A1 Francesco Collamati
A1 Bertani Emilio
A1 Marzia COLANDREA
A1 Angela Collarino
A1 Mahila Ferrari
A1 Luigi Funicelli
A1 Matthias van Oosterom
A1 Chiara Maria Grana
A1 Daria Maccora
A1 Carlo Mancini-Terracciano
A1 Stefano Papi
A1 Eleonora Pisa
A1 Teresa Scotognella
A1 Elena Solfaroli-Camillocci
A1 Renato Valdes Olmos
A1 Fijs van Leeuwen
A1 Riccardo Faccini
YR 2020
UL http://jnm.snmjournals.org/content/61/supplement_1/333.abstract
AB 333Objectives: Radio Guided Surgery (RGS) is a technique helping the surgeon to achieve complete resection of tumours, by means of a radiopharmaceutical that is injected to the patient before surgery, that emits radiation that can be detected intraoperatively by means of a dedicated probe.This technique today uses gamma emitting isotopes together with gamma detecting instruments. A novel approach to RGS using pure beta- decaying isotopes was recently proposed [1], aiming at overcoming major limitations of the current one, that are given by the high penetration of gamma particles.This technique has been initially validated using Y90 as radio isotope (pure B- decay, Emax=2.23MeV) and an organic scintillator as detector element of the probe. Despite having shown a good sensitivity and high efficacy in Y90-DOTATOC applications, in particular in Meningioma and bowel NET ex-vivo samples, the limited number of pure beta- emitting radio pharmaceuticals limits the applicability of this promising technique to few cases. Methods: In this context, i.e. to increase the number of application cases of the beta-RGS technique, we have been investigating new detector technologies/solutions (including solid state detectors), aimed at increasing the sensitivity to low energy particles, that would allow the technique to be performed also with lower-endpoint radio pharmaceuticals. In the same time, we studied also the possibility to use positron emitting radio pharmaceuticals, exploiting the high sensitivity to beta particles of our detector, together with its substantial transparency to photons. In this context, a campaign of ex-vivo tests on Ga-PSMA prostate tumor samples was recently performed. In the meanwhile, laboratory measurements and Monte Carlo simulations regarding a possible application with F18 and Cu isotopes are also ongoing.Finally, a retrospective study on a possible application of beta- RGS with Y90-DOTATOC in pancreatic Neuro Endocrine Tumors has been recently performed. Results: The novel approach to beta RGS demonstrated to be highly effective if performed with pure beta- emitting radiopharmaceuticals in meningioma and bowel NET ex vivo samples. Also pancreatic NETs are expected to be a possible application case. Furthermore, improved detectors allow also the use of positron emitting radio pharmaceuticals, as demonstrated by Ga-PSMA prostate cancer ex-vivo tests, and the use of 18F is also likely to be a possibility. Conclusions: The novel approach to beta RGS we proposed in the past years, initially tailored at pure beta- emitting isotopes, thanks to retrospective studies, ex-vivo tests and detector optimisation is now expanding towards a higher number of application cases. [1] E. S. Camillocci et al., Scientific Reports, 4 (2014), “A novel radioguided surgery technique exploiting beta- decays” 4401.