title: Toward radioguided surgery with β- decays: uptake of a somatostatin analogue, DOTATOC, in meningioma and high-grade glioma.
abstract: A novel radioguided surgery (RGS) technique for cerebral tumors using β(-) radiation is being developed. Checking for a radiotracer that can deliver a β(-) emitter to the tumor is a fundamental step in the deployment of such a technique. This paper reports a study of the uptake of (90)Y-DOTATOC in meningiomas and high-grade gliomas (HGGs) and a feasibility study of the RGS technique in these types of tumor. Estimates were performed assuming the use of a β(-) probe under development with a sensitive area 2.55 mm in radius to detect 0.1-mL residuals.
  
  
  METHODS
  Uptake and background from healthy tissues were estimated on (68)Ga-DOTATOC PET scans of 11 meningioma patients and 12 HGG patients. A dedicated statistical analysis of the DICOM images was developed and validated. The feasibility study was performed using full simulation of emission and detection of the radiation, accounting for the measured uptake and background rate.
  
  
  RESULTS
  All meningioma patients but one with an atypical extracranial tumor showed high uptake of DOTATOC. In terms of feasibility of the RGS technique, we estimated that by administering a 3 MBq/kg activity of radiotracer, the time needed to detect a 0.1-mL remnant with 5% false-negative and 1% false-positive rates is less than 1 s. Actually, to achieve a detection time of 1 s the required activities to administer were as low as 0.2-0.5 MBq/kg in many patients. In HGGs, the uptake was lower than in meningiomas, but the tumor-to-nontumor ratio was higher than 4, which implies that the tracer can still be effective for RGS. It was estimated that by administering 3 mBq/kg of radiotracer, the time needed to detect a 0.1-mL remnant is less than 6 s, with the exception of the only oligodendroma in the sample.
  
  
  CONCLUSIONS
  Uptake of (90)Y-DOTATOC in meningiomas was high in all studied patients. Uptake in HGGs was significantly worse than in meningiomas but was still acceptable for RGS, particularly if further research and development are done to improve the performance of the β(-) probe.
authors.affiliation: Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy INFN Sezione di Roma, Roma, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Collamati
authors.affiliation: Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pepe
authors.affiliation: Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy INFN Sezione di Roma, Roma, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Bellini
authors.affiliation: INFN Sezione di Roma, Roma, Italy.
authors.forename: Valerio
authors.initials: V
authors.lastname: Bocci
authors.affiliation: INFN Sezione di Roma, Roma, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Chiodi
authors.affiliation: Istituto Europeo di Oncologia, Milano, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Cremonesi
authors.affiliation: Laboratori Nazionali di Frascati dell'INFN, Frascati, Italy.
authors.forename: Erika
authors.initials: E
authors.lastname: De Lucia
authors.affiliation: Istituto Europeo di Oncologia, Milano, Italy.
authors.forename: Mahila E
authors.initials: ME
authors.lastname: Ferrari
authors.affiliation: INFN Sezione di Roma, Roma, Italy Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi," Roma, Italy.
authors.forename: Paola M
authors.initials: PM
authors.lastname: Frallicciardi
authors.affiliation: Istituto Europeo di Oncologia, Milano, Italy.
authors.forename: Chiara M
authors.initials: CM
authors.lastname: Grana
authors.affiliation: INFN Sezione di Roma, Roma, Italy Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi," Roma, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Marafini
authors.affiliation: Laboratori Nazionali di Frascati dell'INFN, Frascati, Italy Dipartimento di Fisica, Università RomaTre, Roma, Italy; and.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Mattei
authors.affiliation: INFN Sezione di Roma, Roma, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Morganti
authors.affiliation: INFN Sezione di Roma, Roma, Italy Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Patera
authors.affiliation: INFN Sezione di Roma, Roma, Italy Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Piersanti
authors.affiliation: INFN Sezione di Roma, Roma, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Recchia
authors.affiliation: Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy INFN Sezione di Roma, Roma, Italy Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Roma, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Russomando
authors.affiliation: Laboratori Nazionali di Frascati dell'INFN, Frascati, Italy Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Sarti
authors.affiliation: INFN Sezione di Roma, Roma, Italy Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy.
authors.forename: Adalberto
authors.initials: A
authors.lastname: Sciubba
authors.affiliation: Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy INFN Sezione di Roma, Roma, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Senzacqua
authors.affiliation: Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Roma, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Solfaroli Camillocci
authors.affiliation: INFN Sezione di Roma, Roma, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Voena
authors.affiliation: INFN Sezione di Roma, Roma, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Pinci
authors.affiliation: Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy INFN Sezione di Roma, Roma, Italy riccardo.faccini@roma1.infn.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Faccini
mesh_terms: D001610:Beta Particles; D001692:Biological Transport; D005910:Glioma / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008577:Meningeal Neoplasms / Q000378:metabolism / Q000601:surgery*; D008579:Meningioma / Q000378:metabolism / Q000601:surgery*; D060787:Neoplasm Grading; D015282:Octreotide / Q000031:analogs & derivatives* / Q000737:chemistry / Q000378:metabolism; D013004:Somatostatin / Q000031:analogs & derivatives*; D025321:Surgery, Computer-Assisted / Q000379:methods*
chemical_list: D013004:Somatostatin; C496730:90Y-octreotide, DOTA-Tyr(3)-; D015282:Octreotide
keywords: high-grade glioma; meningioma; radioguided surgery; somatostatin analogue