E Solfaroli Camillocci1, M Schiariti2, V Bocci3, A Carollo4, G Chiodi3, M Colandrea5, F Collamati6, M Cremonesi7, R Donnarumma1, M E Ferrari8, P Ferroli2, F Ghielmetti9, C M Grana5, C Mancini Terracciano1, M Marafini10, S Morganti3, M Patanè11, G Pedroli8, B Pollo11, L Recchia3, A Russomando12, M Toppi13, G Traini1, R Faccini14. 1. Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy. 2. Dip. Neurochirurgia, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy. 3. INFN Sezione di Roma, Roma, Italy. 4. Unità Produzione Radiofarmaci, Istituto Europeo di Oncologia, Milano, Italy. 5. Divisione di Medicina Nucleare, Istituto Europeo di Oncologia, Milano, Italy. 6. INFN Sezione di Roma, Roma, Italy; Dip. Scienze di Base e Applicate per l'Ingegneria, Sapienza Univ. di Roma, Roma, Italy. 7. Unità Ricerca sulle Radiazioni, Istituto Europeo di Oncologia, Milano, Italy. 8. Servizio Fisica Sanitaria, Istituto Europeo di Oncologia, Milano, Italy. 9. Dip. Neurochirurgia, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy; U.O. Direzione Sanitaria IRCCS Carlo Besta, Italy. 10. Museo Storico della Fisica e Centro Studi e Ricerche "E. Fermi", Roma, Italy; INFN Sezione di Roma, Roma, Italy. 11. U.O. Anatomia Patologica, Fondazione Istituto Neurologico Carlo Besta, Milano, Italy. 12. 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. 13. INFN Sezione di Roma, Roma, Italy; INFN Laboratori Nazionali di Frascati, Frascati, Italy. 14. Dip. Fisica, Sapienza Univ. di Roma, Roma, Italy; INFN Sezione di Roma, Roma, Italy. Electronic address: riccardo.faccini@roma1.infn.it.
Abstract
PURPOSE: 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.
PURPOSE: 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 meningiomapatient. 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.