Radioguided surgery with β- radiation in pancreatic Neuroendocrine Tumors: a feasibility study.
Francesco CollamatiDaria MaccoraSergio AlfieriValerio BocciAntonella CartoniAngela CollarinoMicol De SimoniMarta FischettiEmiliano ZampettiAlessandro GiordanoCarlo Mancini-TerraccianoRiccardo MirabelliSilvio MorgantiGiuseppe QueroDante RotiliTeresa ScotognellaElena Solfaroli CamillocciGiacomo TrainiAndrea BearzottiRiccardo FacciniPublished in: Scientific reports (2020)
The possibility to use β- decaying isotopes for radioguided surgery (RGS) has been recently proposed, and first promising tests on ex-vivo samples of Meningioma and intestinal Neuroendocrine Tumor (NET) have been published. This paper reports a study of the uptake of 68Ga-DOTATOC in pancreatic NETs (pNETs) in order to assess the feasibility of a new RGS approach using 90Y-DOTATOC. Tumor and healthy pancreas uptakes were estimated from 68Ga-DOTATOC PET/CT scans of 30 patients with pNETs. From the obtained SUVs (Standardised Uptake Value) and TNRs (Tumor Non tumor Ratio), an analysis algorithm relying on a Monte Carlo simulation of the detector has been applied to evaluate the performances of the proposed technique. Almost all considered patients resulted to be compatible with the application of β--RGS assuming to administer 1.5 MBq/kg of activity of 90Y-DOTATOC 24 h before surgery, and a sampling time of few seconds. In just 2 cases the technique would have required a mildly increased amount of activity or of sampling time. Despite a high physiological uptake of 68Ga-DOTATOC in the healthy pancreas, the proposed RGS technique promises to be effective. This approach allows RGS to find application also in pancreatic diseases, where traditional techniques are not viable.
Keyphrases
- pet ct
- minimally invasive
- positron emission tomography
- coronary artery bypass
- neuroendocrine tumors
- machine learning
- surgical site infection
- computed tomography
- magnetic resonance imaging
- magnetic resonance
- newly diagnosed
- systematic review
- radiation therapy
- randomized controlled trial
- prognostic factors
- acute coronary syndrome
- percutaneous coronary intervention
- electronic health record
- patient reported
- optic nerve
- drug induced
- adverse drug