BACKGROUND: Assessing cancer margins, lymph nodes, and small cancer deposits intraoperatively can be challenging. A new device has become available that allows the detection of positron emission tomography (PET) radiotracers through both high-energy gamma and short-range beta emissions. These PET probes are handheld, allowing for real-time evaluation of cancer using a tool that provides surgeons with better intraoperative assessment of tumor sites. METHODS: Within the context of two institutional review board (IRB)-approved protocols investigating new applications of antibody-labeled PET scanning, (124)I-labeled humanized monoclonal antibodies specific for colorectal cancer (huA33) and renal tumors (cG250) were constructed. Patients underwent preoperative PET scans, approximately seven days post-tracer infusion, when tumor-to-nontumor ratios were high. Suspected tumor deposits were evaluated intraoperatively with handheld beta and gamma PET probes. RESULTS: Handheld PET probes detected emissions from all tumors. Count rates from the gamma probe on tumor ranged from 48 to 306 cps, and for the beta probe ranged from 18 to 190 cps. Gamma and beta emissions exhibited a strong positive correlation. The ratio of gamma and beta counts was at least twice that of the background counts for all tumors evaluated. CONCLUSIONS: This study is the first to demonstrate the utility of beta probes for the intraoperative detection of radiolabeled antibodies targeting cancer. Importantly, the recorded beta count rates from the beta probe correlate with the count rates from the high-energy gamma probe. Furthermore, the beta probe may offer superior specificity for real-time localization of small tumor deposits, compared to gamma probes. The intraoperative portable PET probe may prove a valuable bridge to combining tumor biology and PET technology to guide surgical therapy.
BACKGROUND: Assessing cancer margins, lymph nodes, and small cancer deposits intraoperatively can be challenging. A new device has become available that allows the detection of positron emission tomography (PET) radiotracers through both high-energy gamma and short-range beta emissions. These PET probes are handheld, allowing for real-time evaluation of cancer using a tool that provides surgeons with better intraoperative assessment of tumor sites. METHODS: Within the context of two institutional review board (IRB)-approved protocols investigating new applications of antibody-labeled PET scanning, (124)I-labeled humanized monoclonal antibodies specific for colorectal cancer (huA33) and renal tumors (cG250) were constructed. Patients underwent preoperative PET scans, approximately seven days post-tracer infusion, when tumor-to-nontumor ratios were high. Suspected tumor deposits were evaluated intraoperatively with handheld beta and gamma PET probes. RESULTS: Handheld PET probes detected emissions from all tumors. Count rates from the gamma probe on tumor ranged from 48 to 306 cps, and for the beta probe ranged from 18 to 190 cps. Gamma and beta emissions exhibited a strong positive correlation. The ratio of gamma and beta counts was at least twice that of the background counts for all tumors evaluated. CONCLUSIONS: This study is the first to demonstrate the utility of beta probes for the intraoperative detection of radiolabeled antibodies targeting cancer. Importantly, the recorded beta count rates from the beta probe correlate with the count rates from the high-energy gamma probe. Furthermore, the beta probe may offer superior specificity for real-time localization of small tumor deposits, compared to gamma probes. The intraoperative portable PET probe may prove a valuable bridge to combining tumor biology and PET technology to guide surgical therapy.
Authors: Chaitanya R Divgi; Neeta Pandit-Taskar; Achim A Jungbluth; Victor E Reuter; Mithat Gönen; Shutian Ruan; Christine Pierre; Andrew Nagel; Daniel A Pryma; John Humm; Steven M Larson; Lloyd J Old; Paul Russo Journal: Lancet Oncol Date: 2007-04 Impact factor: 41.316
Authors: Israt S Alam; Idan Steinberg; Ophir Vermesh; Nynke S van den Berg; Eben L Rosenthal; Gooitzen M van Dam; Vasilis Ntziachristos; Sanjiv S Gambhir; Sophie Hernot; Stephan Rogalla Journal: Mol Imaging Biol Date: 2018-10 Impact factor: 3.488
Authors: Krista J Hachey; Christopher S Digesu; Katherine W Armstrong; Denis M Gilmore; Onkar V Khullar; Brian Whang; Hisashi Tsukada; Yolonda L Colson Journal: J Thorac Cardiovasc Surg Date: 2017-02-10 Impact factor: 5.209
Authors: Stephan Rogalla; Sebastiaan C M Joosten; Israt S Alam; Sanjiv S Gambhir; Ophir Vermesh Journal: Mol Ther Date: 2018-02-02 Impact factor: 11.454
Authors: Stephen P Povoski; Ryan L Neff; Cathy M Mojzisik; David M O'Malley; George H Hinkle; Nathan C Hall; Douglas A Murrey; Michael V Knopp; Edward W Martin Journal: World J Surg Oncol Date: 2009-01-27 Impact factor: 2.754
Authors: Stijn Keereweer; Jeroen D F Kerrebijn; Pieter B A A van Driel; Bangwen Xie; Eric L Kaijzel; Thomas J A Snoeks; Ivo Que; Merlijn Hutteman; Joost R van der Vorst; J Sven D Mieog; Alexander L Vahrmeijer; Cornelis J H van de Velde; Robert J Baatenburg de Jong; Clemens W G M Löwik Journal: Mol Imaging Biol Date: 2011-04 Impact factor: 3.488
Authors: Rick G Pleijhuis; Maurits Graafland; Jakob de Vries; Joost Bart; Johannes S de Jong; Gooitzen M van Dam Journal: Ann Surg Oncol Date: 2009-07-17 Impact factor: 5.344
Authors: Lissett R Bickford; Robert J Langsner; Joseph Chang; Laura C Kennedy; Germaine D Agollah; Rebekah Drezek Journal: J Oncol Date: 2012-10-22 Impact factor: 4.375