Purpose: Radioguided surgery (RGS) is a technique that helps the surgeon to achieve a tumour resection as complete as possible, by means of the intraoperative detection of particles emitted by a radiotracer that bounds to tumoural cells. This study aimed to investigate the applicability of beta-RGS for tumour resection and margin assessment in cervical cancer patients preoperatively injected with [F-18]FDG, by means of Monte Carlo simulations.Methods: Patients were retrospectively included if they had a recurrent or persistent cervical cancer, underwent preoperative PET/CT to exclude distant metastases and received radical surgery. All PET/CT images were analysed extracting tumour SUVmax, background SUVmean and tumour-to-non-tumour ratio. These values were used to obtain the expected count rate in a realistic surgical scenario by means of a Monte Carlo simulation of the beta probe, assuming the injection of 2 MBq/kg of [F-18]FDG 60 min before surgery.Results: Thirty-eight patients were included. A measuring time of similar to 2-3 s is expected to be sufficient for discriminating the tumour from background in a given lesion, being this the time the probe has to be over the sample in order to be able to discriminate tumour from healthy tissue with a sensitivity of similar to 99% and a specificity of at least 95%.Conclusion: This study presents the first step towards a possible application of our beta-RGS technique in cervical cancer. Results suggest that this approach to beta-RGS could help surgeons distinguish tumour margins from surrounding healthy tissue, even in a setting of high radiotracer background activity.

Collarino, A., Florit, A., Bizzarri, N., Lanni, V., Morganti, S., De Summa, M., Vizzielli, G., Fanfani, F., Mirabelli, R., Ferrandina, M. G., Scambia, G., Rufini, V., Faccini, R., Collamati, F., Radioguided surgery with β decay: A feasibility study in cervical cancer, <<PHYSICA MEDICA>>, 2023; (113): 1-9. [doi:10.1016/j.ejmp.2023.102658] [https://hdl.handle.net/10807/283356]

Radioguided surgery with β decay: A feasibility study in cervical cancer

Florit, Anita;Lanni, Valerio;Vizzielli, Giuseppe;Fanfani, Francesco;Ferrandina, Maria Gabriella;Scambia, Giovanni;Rufini, Vittoria;
2023

Abstract

Purpose: Radioguided surgery (RGS) is a technique that helps the surgeon to achieve a tumour resection as complete as possible, by means of the intraoperative detection of particles emitted by a radiotracer that bounds to tumoural cells. This study aimed to investigate the applicability of beta-RGS for tumour resection and margin assessment in cervical cancer patients preoperatively injected with [F-18]FDG, by means of Monte Carlo simulations.Methods: Patients were retrospectively included if they had a recurrent or persistent cervical cancer, underwent preoperative PET/CT to exclude distant metastases and received radical surgery. All PET/CT images were analysed extracting tumour SUVmax, background SUVmean and tumour-to-non-tumour ratio. These values were used to obtain the expected count rate in a realistic surgical scenario by means of a Monte Carlo simulation of the beta probe, assuming the injection of 2 MBq/kg of [F-18]FDG 60 min before surgery.Results: Thirty-eight patients were included. A measuring time of similar to 2-3 s is expected to be sufficient for discriminating the tumour from background in a given lesion, being this the time the probe has to be over the sample in order to be able to discriminate tumour from healthy tissue with a sensitivity of similar to 99% and a specificity of at least 95%.Conclusion: This study presents the first step towards a possible application of our beta-RGS technique in cervical cancer. Results suggest that this approach to beta-RGS could help surgeons distinguish tumour margins from surrounding healthy tissue, even in a setting of high radiotracer background activity.
2023
Inglese
Collarino, A., Florit, A., Bizzarri, N., Lanni, V., Morganti, S., De Summa, M., Vizzielli, G., Fanfani, F., Mirabelli, R., Ferrandina, M. G., Scambia, G., Rufini, V., Faccini, R., Collamati, F., Radioguided surgery with β decay: A feasibility study in cervical cancer, <<PHYSICA MEDICA>>, 2023; (113): 1-9. [doi:10.1016/j.ejmp.2023.102658] [https://hdl.handle.net/10807/283356]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/283356
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