Abstract
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.
Highlights
SUV TNRa sensitivity analysis has been performed to evaluate the discriminating power of the proposed technique, having assumed a fixed probing time of tprobe = 3s, and varying the threshold value in terms of total number of counts obtained in this time interval
It has to be stressed that the average value of background SUV has been found to be significantly higher than in previous studies dedicated to assessing the feasibility of the proposed β-radioguided surgery (RGS) technique in other application cases
This was an expected finding, since healthy pancreas is known for its elevated physiological uptake, that has hindered so far any application of traditional Radio Guided Surgery, i.e. exploiting γ decays, notwithstanding the availability of possible radio-pharmaceuticals like 177Lu-DOTATATE
Summary
The aim of this study is to evaluate the possibility to apply β-RGS to pancreatic NETs, using 90Y-DOTATOC as radio-pharmaceutical. The goal of this study was to evaluate the possibility to apply an innovative β−-RGS technique to pancreatic Neuroendocrine Tumors with 90Y-DOTATOC, using a detector that has been recently developed and tested on Meningioma and bowel NET ex-vivo samples
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