Time Evolution of DOTATOC Uptake in Neuroendocrine Tumors in View of a Possible Application of Radioguided Surgery with β− Decay
Francesco Collamati,F. Bellini,V. Bocci,Erika De Lucia,Valentina Ferri,Federica Fioroni,Elisa Grassi,Mauro Iori,Michela Marafini,Silvio Morganti,Riccardo Paramatti,Vincenzo Patera,L. Recchia,A. Russomando,Alessio Sarti,Adalberto Sciubba,M. Senzacqua,Elena Solfaroli Camillocci,Annibale Versari,C. Voena,Riccardo Faccini +20 more
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TLDR
If 90Y-DOTATOC is used with liver NET metastases, the proposed RGS technique is believed to be feasible by injecting an activity that is one third of that commonly used for PET imaging, and this characteristic can be exploited when a radiotracer with a long half-life, such as 90Y, is used.Abstract:
A novel radioguided surgery (RGS) technique exploiting β− radiation has been proposed. To develop such a technique, a suitable radiotracer able to deliver a β− emitter to the tumor has to be identified. A first candidate is represented by 90Y-labeled DOTATOC, a compound commonly used today for peptide radioreceptor therapy. The application of this β− RGS to neuroendocrine tumors (NET) requires study of the uptake of DOTATOC and its time evolution both in tumors and in healthy organs and evaluation of the corresponding performance of the technique. Methods: Uptake by lesions and healthy organs (kidneys, spleen, liver and healthy muscle) was estimated on 177Lu-DOTATOC SPECT/CT scans of 15 patients affected by NET with different localizations, treated at IRCCS–Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. For each patient, SPECT/CT images, acquired at 0.5, 4, 20, 40, and 70 h after injection, were studied. For each lesion, the tumor-to-nontumor ratio (TNR) with respect to all healthy organs and its time evolution were studied. A subset of patients showing hepatic lesions was selected, and the TNR with respect to the nearby healthy tissue was calculated. By means of a Monte Carlo simulation of the probe for β− RGS, the activity that is to be administered for a successful detection was estimated lesion-by-lesion. Results: Uptake of DOTATOC on NETs maximized at about 24 h after injection. The cases of hepatic lesions showed a TNR with respect to the tumor margins compatible with the application of β− RGS. In particular, 0.1-mL residuals are expected to be detectable within 1 s with 5% false-negative and 1% false-positive by administering the patient as little as 1 MBq/kg. Conclusion: The balance between tumor uptake and metabolic washout in healthy tissue causes the TNR to increase with time, reaching its maximum after 24 h, and this characteristic can be exploited when a radiotracer with a long half-life, such as 90Y, is used. In particular, if 90Y-DOTATOC is used with liver NET metastases, the proposed RGS technique is believed to be feasible by injecting an activity that is one third of that commonly used for PET imaging.read more
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Journal ArticleDOI
First ex vivo validation of a radioguided surgery technique with β-radiation
E. Solfaroli Camillocci,Marco Schiariti,V. Bocci,A. Carollo,G. Chiodi,Marzia Colandrea,Francesco Collamati,Marta Cremonesi,Raffaella Donnarumma,Mahila Ferrari,Paolo Ferroli,F. Ghielmetti,Chiara Maria Grana,C. Mancini Terracciano,M. Marafini,S. Morganti,Monica Patanè,Guido Pedroli,Bianca Pollo,L. Recchia,A. Russomando,M. Toppi,Giacomo Traini,R. Faccini +23 more
TL;DR: 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.
Journal ArticleDOI
A DROP-IN beta probe for robot-assisted 68 Ga-PSMA radioguided surgery: first ex vivo technology evaluation using prostate cancer specimens
Francesco Collamati,Matthias N. van Oosterom,Matthias N. van Oosterom,Micol De Simoni,Micol De Simoni,Riccardo Faccini,Riccardo Faccini,M. Fischetti,M. Fischetti,Carlo Mancini Terracciano,Carlo Mancini Terracciano,R. Mirabelli,R. Mirabelli,Roberto Moretti,Roberto Moretti,Judith olde Heuvel,Elena Solfaroli Camillocci,Elena Solfaroli Camillocci,Florian van Beurden,Florian van Beurden,Henk G. van der Poel,Renato A. Valdés Olmos,Pim J. van Leeuwen,Fijs W. B. van Leeuwen,Fijs W. B. van Leeuwen,Silvio Morganti +25 more
TL;DR: The feasibility of beta-radioguided surgery in a robotic context by means of a DROP-INβ detector is demonstrated and this technique could provide a valuable tool in detecting tumor remnants on the prostate surface and in confirmation of PSMA-PET positive lymph nodes.
Journal ArticleDOI
Radioguided surgery with β radiation: a novel application with Ga68.
Francesco Collamati,V. Bocci,Paolo Castellucci,Micol De Simoni,Micol De Simoni,Stefano Fanti,Riccardo Faccini,Riccardo Faccini,Alessandro Giordano,Daria Maccora,Carlo Mancini-Terracciano,M. Marafini,R. Mirabelli,R. Mirabelli,Silvio Morganti,Riccardo Schiavina,Teresa Scotognella,Giacomo Traini,Giacomo Traini,Elena Solfaroli Camillocci,Elena Solfaroli Camillocci +20 more
TL;DR: The possibility to extendRadio Guided Surgery cases to 68Ga, a β+ emitting isotope widely used today in nuclear medicine, is discussed, analysing their 68Ga-PSMA PET images to asses if the molecule uptake is enough to apply this technique.
Journal ArticleDOI
Feasibility of beta-particle radioguided surgery for a variety of “nuclear medicine” radionuclides
Carlo Mancini-Terracciano,Raffaella Donnarumma,Gaia Bencivenga,V. Bocci,Antonella Cartoni,Francesco Collamati,Ilaria Fratoddi,Alessandro Giordano,Luca Indovina,Daria Maccora,Michela Marafini,R. Mirabelli,Silvio Morganti,Dante Rotili,A. Russomando,Teresa Scotognella,Elena Solfaroli Camillocci,M. Toppi,Giacomo Traini,Iole Venditti,Riccardo Faccini +20 more
TL;DR: Beta-particle radioguided tumor resection may potentially overcome the limitations of conventional gamma-ray guided surgery by eliminating, or at least minimizing, the confounding effect of counts contributed by activity in adjacent normal tissues by evaluating the clinical feasibility of this approach for a variety of radionuclides.
Journal ArticleDOI
Radioguided surgery with radiolabeled somatostatin analogs: not only in GEP-NETs
TL;DR: A promising and effective employment of RGS may be found in neuroendocrine tumors (NETs) using 111In-pentetreotide (OCT), and preliminary studies with b- probes using 90Y-SSA suggest the possible interest of this approach in patients undergoing peptide receptor radiotherapy.
References
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