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Beta radioguided surgery: towards routine implementation?

Francesco Collamati1, Matthias N van Oosterom2,3, Boris A Hadaschik4,5

  • 1National Institute of Nuclear Physics, Rome, Italy - francesco.collamati@roma1.infn.it.

The Quarterly Journal of Nuclear Medicine and Molecular Imaging : Official Publication of the Italian Association of Nuclear Medicine (AIMN) [And] the International Association of Radiopharmacology (IAR), [And] Section of the Society Of
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Summary
This summary is machine-generated.

Beta radioguided surgery (RGS) offers a promising method for intraoperative detection of residual tumor tissue in solid tumors. This technique aims to improve surgical outcomes by enabling precise resection of malignant areas, reducing recurrence and metastasis.

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Nuclear Medicine

Background:

  • Surgery is a primary treatment for solid tumors, but conservative resections can lead to residual disease, recurrence, and metastases.
  • Current methods lack the precision to reliably detect small cancerous tissues intraoperatively, complicating complete tumor removal.
  • Image-guided surgery, specifically beta radioguided surgery (RGS), presents a potential solution for enhanced intraoperative tumor detection.

Purpose of the Study:

  • To provide a comprehensive review of beta radioguided surgery (RGS) principles and applications.
  • To discuss the clinical feasibility of beta RGS, including the role of Cerenkov radiation.
  • To highlight the potential of beta RGS as a complementary technique in surgical oncology.

Main Methods:

  • Review of physical principles differentiating beta and gamma radiation in surgical guidance.
  • Discussion of recent advancements and clinical feasibility studies of beta RGS.
  • Exploration of various radiopharmaceuticals (beta+ and beta-) utilized in beta RGS.

Main Results:

  • Beta RGS leverages distinct physical properties compared to gamma radiation, offering potential advantages for intraoperative detection.
  • Emerging techniques like Cerenkov radiation imaging show clinical feasibility for RGS.
  • Both beta-emitting and positron-emitting radiotracers are being investigated for beta RGS, with promising ex vivo and in vivo results.

Conclusions:

  • Beta RGS demonstrates significant potential as an adjunct to standard surgical procedures for solid tumors.
  • The technique's ability to precisely detect residual tumor tissue could reduce local recurrence and metastasis.
  • Further clinical trials are warranted to validate the efficacy and establish the clinical value of beta RGS technologies.