INFN Sec. of Rome, P.le A. Moro 2, 00185, Rome, Italy.
Nuclear Medicine Unit, Fondazione Policlinico Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy.
Sci Rep. 2020 Mar 4;10(1):4015. doi: 10.1038/s41598-020-61075-2.
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 Ga-DOTATOC in pancreatic NETs (pNETs) in order to assess the feasibility of a new RGS approach using Y-DOTATOC. Tumor and healthy pancreas uptakes were estimated from Ga-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 Y-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 Ga-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.
β 衰变同位素在放射性导向手术（RGS）中的应用可能性最近被提出，并且已经发表了关于脑膜瘤和肠神经内分泌肿瘤（NET）离体样本的首次有前景的测试结果。本文报告了一项关于 Ga-DOTATOC 在胰腺神经内分泌肿瘤（pNET）中摄取的研究，旨在评估使用 Y-DOTATOC 进行新的 RGS 方法的可行性。从 30 名 pNET 患者的 Ga-DOTATOC PET/CT 扫描中估计了肿瘤和健康胰腺的摄取。从获得的 SUV（标准化摄取值）和 TNR（肿瘤/非肿瘤比）中，应用了一种依赖于探测器蒙特卡罗模拟的分析算法，以评估所提出技术的性能。几乎所有考虑的患者都适合在手术前 24 小时给予 1.5 MBq/kg 的 Y-DOTATOC 活性，并在几秒钟内进行采样，假设应用 β-RGS。只有在 2 种情况下，该技术将需要略微增加活性或采样时间。尽管 Ga-DOTATOC 在健康胰腺中具有较高的生理摄取，但所提出的 RGS 技术有望有效。这种方法允许 RGS 在胰腺疾病中找到应用，在这些疾病中，传统技术不可行。
