Francesco Collamati1, Alessandra Pepe2, Fabio Bellini1, Valerio Bocci3, Giacomo Chiodi3, Marta Cremonesi4, Erika De Lucia5, Mahila E Ferrari4, Paola M Frallicciardi6, Chiara M Grana4, Michela Marafini6, Ilaria Mattei7, Silvio Morganti3, Vincenzo Patera8, Luca Piersanti8, Luigi Recchia3, Andrea Russomando9, Alessio Sarti10, Adalberto Sciubba8, Martina Senzacqua1, Elena Solfaroli Camillocci11, Cecilia Voena3, Davide Pinci3, Riccardo Faccini12. 1. Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy INFN Sezione di Roma, Roma, Italy. 2. Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy. 3. INFN Sezione di Roma, Roma, Italy. 4. Istituto Europeo di Oncologia, Milano, Italy. 5. Laboratori Nazionali di Frascati dell'INFN, Frascati, Italy. 6. INFN Sezione di Roma, Roma, Italy Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi," Roma, Italy. 7. Laboratori Nazionali di Frascati dell'INFN, Frascati, Italy Dipartimento di Fisica, Università RomaTre, Roma, Italy; and. 8. INFN Sezione di Roma, Roma, Italy Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy. 9. 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. 10. Laboratori Nazionali di Frascati dell'INFN, Frascati, Italy Dipartimento di Scienze di Base e Applicate per l'Ingegneria, Sapienza Università di Roma, Roma, Italy. 11. Center for Life Nano Science@Sapienza, Istituto Italiano di Tecnologia, Roma, Italy. 12. Dipartimento di Fisica, Sapienza Università di Roma, Roma, Italy INFN Sezione di Roma, Roma, Italy riccardo.faccini@roma1.infn.it.
Abstract
UNLABELLED: 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. CONCLUSION: 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.
UNLABELLED: 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 meningiomapatients 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 meningiomapatients 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. CONCLUSION: 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: B M Dijkstra; A Motekallemi; W F A den Dunnen; J R Jeltema; G M van Dam; F A E Kruyt; R J M Groen Journal: Acta Neurochir (Wien) Date: 2018-06-01 Impact factor: 2.216