[Peroperative detection probes. Evaluation and perspectives in endocrinology].
The principal primary endocrine tumors may be visualized scintigraphically by injection of highly specific radiopharmaceuticals. When surgery is indicated, the surgeon may be assisted in difficult cases by a probe detecting the radioactivity concentrated in tumoral tissue. A radiopharmaceutical consists of a vector molecule labeled with a radioactive isotope. Only radioactive emissions with a certain half life and energy are suitable for intraoperative detection; this limits the number of usable radionuclides. In practice, one uses iodine 123 (123I), iodine 125 (125I), and iodine 131 (131I) labeled metaiodobenzylguanidine mIBG or indium 111 (111In) labeled pentetreotide (Octreoscan) or bi-specific anti CEA antibody. During intra-operative detection, the probe is closely positioned to the tumor-tissue which is surrounded by radioactive background activity due to the non-specific binding in adjacent organs. In order to work with probes that are easily handled, and sensitive at the same time, one can opt for technology which uses either diodes or scintillating crystals. These probes can be used at room temperature and their choice depends upon the energy to be detected. Interesting results begin to be published concerning pheocyromocytomas, differentiated thyroid carcinomas, gastro-entero-pancreatic tumors and medullary thyroid carcinoma, especially for reintervention when conventional imaging modalities fail to localize tumors.
Tenenbaum
F
F
Hôpital Cochin, Service de Médecine Nucléaire, Paris.
Ricard
M
M
D019797:3-Iodobenzylguanidine; D004701:Endocrine Gland Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007205:Indium Radioisotopes; D007432:Intraoperative Period; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D015335:Molecular Probes; D011877:Radionuclide Imaging; D013004:Somatostatin / Q000031:analogs & derivatives
D007205:Indium Radioisotopes; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D015335:Molecular Probes; D019797:3-Iodobenzylguanidine; D013004:Somatostatin; C081788:pentetreotide