Division of Digestive Surgery, Istituto Europeo di Oncologia, IRCCS, Milano, Italy.
Sezione di Roma, Istituto Nazionale di Fisica Nucleare, Roma, Italy.
Cancer Biother Radiopharm. 2021 Jun;36(5):397-406. doi: 10.1089/cbr.2020.4487. Epub 2021 Feb 18.
In neuroendocrine tumor (NET), complete surgery could better the prognosis. Radioguided surgery (RGS) with β-radioisotopes is a novel approach focused on developing a new probe that, detecting electrons and operating with low background, provides a clearer delineation of the lesions with low radiation exposition for surgeons. As a first step to validate this procedure, specimens of tumors expressing somatostatin receptors, as small intestine neuroendocrine tumor (SI-NET), were tested. SI-NET presents a high uptake of a beta-emitting radiotracer, Y-DOTATOC. Five SI-NET patients were enrolled after performing a Ga-DOTATOC positron emission tomography/computed tomography (CT) and a CT enterography; 24 h before surgery, they received 5 mCi of Y-DOTATOC. Surgery was performed as routine. Tumors and surrounding tissue were sectioned in different samples and examined with the beta-detecting probe. All the tumor samples showed high counts of radioactivity that was up to a factor of 18 times higher than the corresponding cutoff value, with a sensitivity of 96% and a specificity of 100%. These first RGS tests showed that this probe can discriminate very effectively between tumor and healthy tissues by the administration of low activities of Y-DOTATOC, allowing more precise surgery.
在神经内分泌肿瘤 (NET) 中，完全手术可以改善预后。放射性导向手术 (RGS) 结合β放射性同位素是一种新的方法，旨在开发一种新的探针，该探针可以检测电子并以低背景运行，为外科医生提供更清晰的病变描绘，同时暴露于低辐射下。作为验证该程序的第一步，测试了表达生长抑素受体的肿瘤标本，如小肠神经内分泌肿瘤 (SI-NET)。SI-NET 对 β 发射放射性示踪剂 Y-DOTATOC 具有高摄取率。在进行 Ga-DOTATOC 正电子发射断层扫描/计算机断层扫描 (CT) 和 CT 肠造影后，对 5 名 SI-NET 患者进行了入组；在手术前 24 小时，他们接受了 5 mCi 的 Y-DOTATOC。手术按常规进行。肿瘤和周围组织被切成不同的样本，并使用β检测探针进行检查。所有肿瘤样本的放射性计数都很高，高达相应截止值的 18 倍，灵敏度为 96%，特异性为 100%。这些初步的 RGS 测试表明，通过给予低剂量的 Y-DOTATOC，该探针可以非常有效地区分肿瘤和健康组织，从而实现更精确的手术。
