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Register a new userA novel radioguided surgery technique exploiting $beta^{-}$ decays
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The background induced by the high penetration power of the gamma radiation is the main limiting factor of the current Radio-guided surgery (RGS). To partially mitigate it, a RGS with beta+ emitting radio-tracers has been suggested in literature. Here we propose the use of beta- emitting radio-tracers and beta- probes and discuss the advantage of this method with respect to the previously explored ones: the electron low penetration power allows for simple and versatile probes and could extend RGS to tumours for which background originating from nearby healthy tissue makes gamma probes less effective. We developed a beta- probe prototype and studied its performances on phantoms. By means of a detailed simulation we have also extrapolated the results to estimate the performances in a realistic case of meningioma, pathology which is going to be our first in-vivo test case. A good sensitivity to residuals down to 0.1ml can be reached within 1s with an administered activity smaller than those for PET-scans thus making the radiation exposure to medical personnel negligible.
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A novel radio guided surgery (RGS) technique for cerebral tumors using $beta^{-}$ radiation is being developed. Checking the availability of a radio-tracer that can deliver a $beta^{-}$ emitter to the tumor is a fundamental step in the deployment of such technique. This paper reports a study of the uptake of 90Y labeled (DOTATOC) in the meningioma and the high grade glioma (HGG) and a feasibility study of the RGS technique in these cases.
Purpose: A radio-guided surgery technique with beta- -emitting radio-tracers was suggested to overcome the effect of the large penetration of gamma 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 300 MBq of 90Y-DOTATOC. Several samples extracted from the meningioma and the nearby Dura Mater were analyzed with a beta- 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 (105 cps) and a significant signal on residuals of $sim$0.2 ml (28 cps). We also show that simulations predict correctly the observed yields and this allows us to estimate that the healthy tissues would return negligible signals (~1 cps). 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.
The development of the $beta^-$ based radio-guided surgery aims to extend the technique to those tumours where surgery is the only possible treatment and the assessment of the resection would most profit from the low background around the lesion, as for brain tumours. Feasibility studies on meningioma, glioma, and neuroendocrine tumors already estimated the potentiality of this new treatment. To validate the technique, prototypes of the intraoperative probe required by the technique to detect $beta^-$ radiation have been developed. This paper discusses the design details of the device and the tests performed in laboratory. In such tests particular care has to be taken to reproduce the surgical field conditions. The innovative technique to produce specific phantoms and the dedicated testing protocols is described in detail.
Samples of uterine leiomyomatis and normal tissues taken from patients after surgery were investigated using the Positron Annihilation Lifetime Spectroscopy (PALS). Significant differences in all PALS parameters between normal and diseased tissues were observed. For all studied patients, it was found that the values of the free annihilation and ortho-positronium lifetime are larger for the tumorous tissues than for the healthy ones. For most of the patients, the intensity of the free annihilation and ortho-positronium annihilation was smaller for the tumorous than for the healthy tissues. For the first time, in this kind of studies, the $3gamma$ fraction of positron annihilation was determined to describe changes in the tissue porosity during morphologic alteration.
Proton beam therapy can potentially offer improved treatment for cancers of the head and neck and in paediatric patients. There has been a sharp uptake of proton beam therapy in recent years as improved delivery techniques and patient benefits are observed. However, treatments are currently planned using conventional x-ray CT images due to the absence of devices able to perform high quality proton computed tomography (pCT) under realistic clinical conditions. A new plastic-scintillator-based range telescope concept, named ASTRA, is proposed here as the energy tagging detector of a pCT system. Simulations conducted using Geant4 yield an expected energy resolution of 0.7% and have demonstrated the ability of ASTRA to track multiple protons simultaneously. If calorimetric information is used the energy resolution could be further improved to about 0.5%. Assuming clinical beam parameters the system is expected to be able to efficiently reconstruct at least, 10$^8$ protons/s. The performance of ASTRA has been tested by imaging phantoms to evaluate the image contrast and relative stopping power reconstruction.
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