First ex vivo validation of a radioguided surgery technique with β-radiation.
OBJECTIVE
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 300MBq 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 (105cps) and a significant signal on residuals of ∼0.2ml (28cps). We also show that simulations predict correctly the observed yields and this allows us to estimate that the healthy tissues would return negligible signals (≈1cps). 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.
Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy.
E
E
Solfaroli Camillocci
Dip. Neurochirurgia, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
M
M
Schiariti
INFN Sezione di Roma, Roma, Italy.
V
V
Bocci
Unità Produzione Radiofarmaci, Istituto Europeo di Oncologia, Milano, Italy.
A
A
Carollo
INFN Sezione di Roma, Roma, Italy.
G
G
Chiodi
Divisione di Medicina Nucleare, Istituto Europeo di Oncologia, Milano, Italy.
M
M
Colandrea
INFN Sezione di Roma, Roma, Italy; Dip. Scienze di Base e Applicate per l'Ingegneria, Sapienza Univ. di Roma, Roma, Italy.
F
F
Collamati
Unità Ricerca sulle Radiazioni, Istituto Europeo di Oncologia, Milano, Italy.
M
M
Cremonesi
Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy.
R
R
Donnarumma
Servizio Fisica Sanitaria, Istituto Europeo di Oncologia, Milano, Italy.
M E
ME
Ferrari
Dip. Neurochirurgia, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
P
P
Ferroli
Dip. Neurochirurgia, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy; U.O. Direzione Sanitaria IRCCS Carlo Besta, Italy.
F
F
Ghielmetti
Divisione di Medicina Nucleare, Istituto Europeo di Oncologia, Milano, Italy.
C M
CM
Grana
Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy.
C
C
Mancini Terracciano
Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy; INFN Sezione di Roma, Roma, Italy.
M
M
Marafini
INFN Sezione di Roma, Roma, Italy.
S
S
Morganti
U.O. Anatomia Patologica, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
M
M
Patanè
Servizio Fisica Sanitaria, Istituto Europeo di Oncologia, Milano, Italy.
G
G
Pedroli
U.O. Anatomia Patologica, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy.
B
B
Pollo
INFN Sezione di Roma, Roma, Italy.
L
L
Recchia
Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy; Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Roma, Italy.
A
A
Russomando
INFN Sezione di Roma, Roma, Italy; INFN Laboratori Nazionali di Frascati, Frascati, Italy.
M
M
Toppi
Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy.
G
G
Traini
Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy. Electronic address: riccardo.faccini@roma1.infn.it.
R
R
Faccini
D000368:Aged; D000465:Algorithms; D001610:Beta Particles; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D003198:Computer Simulation; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008579:Meningioma / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008962:Models, Theoretical; D009010:Monte Carlo Method; D016273:Occupational Exposure / Q000517:prevention & control; D015282:Octreotide / Q000031:analogs & derivatives / Q000737:chemistry; D049268:Positron-Emission Tomography; D011874:Radiometry; D016634:Radiosurgery / Q000379:methods*; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods*
C496730:90Y-octreotide, DOTA-Tyr(3)-; D015282:Octreotide
Brain tumors; Intraoperative imaging; Radio-guided-surgery; decays