Comparison of in vivo scintillation probes and gamma cameras for detection of small, deep tumours

Barber, H. Bradford; Barrett, Harrison H.; Woolfenden, James M.; Myers, Kyle J.; Hickernell, T.S.

doi:10.1088/0031-9155/34/6/008

Cited by 37 publications

(9 citation statements)

References 15 publications

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“…The TNR detection threshold to confidently localize the residual brain tumor was arbitrarily set to 2. To provide a quantitative measurement of the tumor detectability, this signal to noise ratio can be related to an area under a receiver operative characteristic curve of 0.92 corresponding to a good probability of detection [40]. The TNR was measured in two different ways to simulate the two different acquisition modes of the intraoperative probe.…”

Section: ) Performances For Detection Of Residual Radiolabeled Tumorsmentioning

confidence: 99%

Physical Performance of an Intraoperative Beta Probe Dedicated to Glioma Radioguided Surgery

Bogalhas¹,

Ménard²,

Bonzom³

et al. 2008

IEEE Trans. Nucl. Sci.

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The precise delineation and excision of brain tumor extent allows to improve survival outcome and quality of life of surgically treated patients. In order to refine the resection of gliomas, we are developing a novel intraoperative probe specifically dedicated to the localization of residual tumor after the bulk has been excised. The probe, built around clear and plastic scintillating fibers, was designed to detect positrons emitted from radiolabeled brain tissue in order to discriminate more specifically neoplastic from normal tissues. The probe was also built to be directly coupled to the excision tool leading to simultaneous detection and removal of tumor. We report here performances of the first radio-isotopic configuration of the intraoperative probe which consists of a detection head composed of eight detection elements held around the excision tool in a closed packed annular arrangement. This head is coupled to an optic fiber bundle that exports the scintillating light to a multi-channel photomultiplier tube. The ray background generated by the annihilation of + in tissues is eliminated by a real-time subtraction method. The detector exhibits a sensitivity of 139 cps/kBq and a ray rejection efficiency of 99.5%. The ability of the probe to detect residual lesions was evaluated with a realistic brain phantom representing the surgical cavity and the boundaries of the tumor. We showed that lesions as small as 5 mm in diameter can be detected for tumor to normal tissue uptake ratios of fluorinated tracers greater than 3.5. This ratio is achieved with radiopharmaceuticals like 18 F-FET or 18 F-choline. These promising results suggest that the features of our system are compatible with in situ localization of residual radiolabeled tumors.

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Section: ) Performances For Detection Of Residual Radiolabeled Tumorsmentioning

confidence: 99%

Physical Performance of an Intraoperative Beta Probe Dedicated to Glioma Radioguided Surgery

Bogalhas¹,

Ménard²,

Bonzom³

et al. 2008

IEEE Trans. Nucl. Sci.

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“…A key aspect of this work, in contrast to earlier imaging work with low-Z scintillators or semiconductors [12,13,14,15,16,17], is the use of a thinner and higher effective-Z CsI(Tl) scintillator fabricated in the form of a microcolumnar structure. As shown in Figure 1, the scintillator consists of 3 to 5 µm diameter columns of CsI(Tl) Figure 1.…”

Section: The Micro Columnar Csi(tl) Scintillatormentioning

confidence: 99%

Feasibility studies of an EMCCD-based beta imaging probe for radioguided thyroid surgery

et al. 2006

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We are developing a probe for image-guided surgery of cancer to be used in conjunction with traditional beta emitting radiopharmaceuticals such as I 131 and F 18 -FDG. This device is based on a combination of two novel technologies, a microcolumnar film scintillator, CsI(Tl) and low-noise high sensitivity Electron-Multiplying CCD (EMCCD). The former allows high spatial resolution nuclear imaging and the latter facilitates detection of signal with significantly higher SNR than conventional CCDs by the virtue of internal signal gain built into its readout register. CsI(Tl) is bonded to the EMCCD via a flexible coherent fiberopic cable for easy handling. Due to its high sensitivity the probe is capable of functioning in real time providing high spatial resolution nuclear images for precise detection, delineation and excision of tumors. The evaluation of the probe using standard clinical phantoms as well as the operational data obtained on swine models and in clinical surgery will be presented.

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“…Both theoretical considerations and experimental in vitro results predict that, providing the probe can be brought close to the tumor deposit (preferably within a centimeter), sensitivity with a hand-held gamma probe should be superior to that for an external camera across a wide range of radiopharmaceuticals, administered doses, tumor uptake, and camera design. 54 Experience with this approach is accumulating with immune, specific biochemical, and nonspecific physiologic radiopharmaceuticals. 55 Experience with radiolabeled B72.3 MAb and hand-held gamma probe intraoperative detection is described in a series of reports from Ohio State University.…”

Section: Radioimmunoguided Surgerymentioning

confidence: 99%

Newer Imaging Modalities

Berman

Brodsky

1998

Cancer Control

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This regular feature will enhance your knowledge of imaging technology in oncologic diagnosis, treatment, and evaluation. Tissue-Specific and Physiologic Nuclear Medicine Modalities The search for greater sensitivity for detecting small subclinical tumor deposits and improved specificity for distinguishing between malignant and benign masses has led to the development of techniques for linking radioactive labels to tumor-specific antibodies or tissue-specific biochemical agents. 1,2 Major progress is occurring as well in the development of nonspecific physiologic nuclear medicine modalities, most prominent among them being positron emission tomography (PET) and the recently adapted cardiac imaging agents. The current status of these new approaches is discussed below. Tumor-Specific Monoclonal Antibody Radioimmunoscintigraphy The early use of polyclonal murine antitumor antibodies for tumor localization has been succeeded by monoclonal antibody-based agents, although these, too, are of murine origin thus far. 3,4 The majority of agents under development are labeled with either a technetium 99m (99m Tc) or indium 111 (111 In) radiometal chelate. 5 These are popular because of their ease of preparation, their suitability for standard camera imaging, and the compatibility of their half-lives to the in vivo clearance of the antibody proteins. Whole antibodies and large fragments require the longer half-life of 111 In although this carries with it the disadvantage of high liver clearance, compromising imaging within and adjacent to the liver and, to a lesser extent, the gut. Smaller, more quickly cleared antibody Fab' fragments can be labeled advantageously with the shorter half-lived 99m Tc. Technetium is predominantly cleared by the kidneys, and the combination of fast biologic clearance of the antibody fragment and fast renal clearance of the radiolabel should result in less extensive background activity. Despite their theoretical appeal, the performance of these preparations can still be compromised by problems of poor tumor perfusion, low tumor cell-surface antigen representation, antigen heterogeneity, and nonspecific uptake. 5,6 One approach to reducing the confounding effects of high background activity has been the use of background subtraction techniques, as in the use of 99m Tc-labeled albumin in conjunction with 99m Tc-labeled antibody fragments; however, it is not clear whether improved specificity is in fact achieved. 7 A more recent elaboration on this approach has been the fusion of bone scan or computed tomography (CT) images with single-photon emission tomography (SPECT) images of the radioantibody scan. 8 Only limited experience with these approaches is yet reported. 9 An alternative approach attempts to apply the phenomenon of tumor antigen augmentation from exposure to cytokines such as interferon. 10,11 Here, too, the limited published clinical experience is inadequate to predict whether this phenomenon will be the basis of improved imaging performance. 12 A particularly intriguing approach, champ...

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Comparison of in vivo scintillation probes and gamma cameras for detection of small, deep tumours

Cited by 37 publications

References 15 publications

Physical Performance of an Intraoperative Beta Probe Dedicated to Glioma Radioguided Surgery

Physical Performance of an Intraoperative Beta Probe Dedicated to Glioma Radioguided Surgery

Feasibility studies of an EMCCD-based beta imaging probe for radioguided thyroid surgery

Newer Imaging Modalities

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