First ex vivo validation of a radioguided surgery technique with β-radiation. Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Solfaroli Camillocci, E.; Schiariti, M.; Bocci, V.; Carollo, A.; Chiodi, G.; Colandrea, M.; Collamati, F.; Cremonesi, M.; Donnarumma, R.; Ferrari, M.E.; Ferroli, P.; Ghielmetti, F.; Grana, C.M.; Mancini Terracciano, C.; Marafini, M.; Morganti, S.; Patanè, M.; Pedroli, G.; Pollo, B.; Recchia, L.; Russomando, A.; Toppi, M.; Traini, G.; Faccini, R.
• Is Part Of: Physica medica. Volume 32:Issue 9(2016)
• Page Start: 1139
• Page End: 1144
• Publication Date: 2016-09
• Subjects: Radio-guided-surgery -- Brain tumors -- β- decays -- Intraoperative imaging; Medical physics -- Periodicals; Biophysics -- Periodicals; Biophysics -- Periodicals; Imagerie médicale -- Périodiques; Radiothérapie -- Périodiques; Rayons X -- Sécurité -- Mesures -- Périodiques; Physique -- Périodiques; Médecine -- Périodiques; 610.153
• DOI: 10.1016/j.ejmp.2016.08.018
• Languages: English
• ISSNs: 1120-1797

Abstract

Highlights: A novel radio-guided-surgery technique using beta- radiation is under development. Simulations and lab tests demonstrated its potential compared to state-of-the-art. A proof-of-principle test on patient confirmed tracer uptake and probe sensitivity. It also confirmed that the dose delivered to the medical staff is negligible. This is a proof-of-principle, not a case report, nor a clinical trial. Abstract : Purpose: A radio-guided surgery technique with β - -emitting radio-tracers was suggested to overcome the effect of the large penetration of γ radiation. The feasibility studies in the case of brain tumors and abdominal neuro-endocrine tumors were based on simulations starting from PET images with several underlying assumptions. This paper reports, as proof-of-principle of this technique, an ex vivo test on a meningioma patient. This test allowed to validate the whole chain, from the evaluation of the SUV of the tumor, to the assumptions on the bio-distribution and the signal detection. Methods: A patient affected by meningioma was administered 300 MBq of 90 Y-DOTATOC. Several samples extracted from the meningioma and the nearby Dura Mater were analyzed with a β - probe designed specifically for this radio-guided surgery technique. The observed signals were compared both with the evaluation from the histology and with the Monte Carlo simulation. Results: we obtained a large signal on the bulk tumor (105 cps) and a significant signal on residuals of ∼0.2 ml (28 cps). We also show that simulations predict correctly the observed yields and this allows us to estimate that the healthy tissues would return negligible signals (≈1 cps). This test also demonstrated that the exposure of the medical staff is negligible and that among the biological wastes only urine has a significant activity. Conclusions: This proof-of-principle test on a patient assessed that the technique is feasible with negligible background to medical personnel and confirmed that the expectations obtained with Monte Carlo simulations starting from diagnostic PET images are correct.