Handheld PET Probe for Pediatric Cancer Surgery

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2022 May 14

PMID 35565350

Authors

Hannah N Rinehardt

Sadie Longo

Ryan Gilbert

Jennifer N Shoaf

Wilson B Edwards

Gary Kohanbash

Marcus M Malek

Affiliations

Soon will be listed here.

Abstract

18F-fluorodeoxyglucose (FDG) is a glucose analog that acts as a marker for glucose uptake and metabolism. FDG PET scans are used in monitoring pediatric cancers. The handheld PET probe localization of FDG-avid lesions is an emerging modality for radio-guided surgery (RGS). We sought to assess the utility of PET probe in localizing occult FDG-avid tumors in pediatric patients. PET probe functionality was evaluated by using a PET/CT scan calibration phantom. The PET probe was able to detect FDG photon emission from simulated tumors with an expected decay of the radioisotope over time. Specificity for simulated tumor detection was lower in a model that included background FDG. In a clinical model, eight pediatric patients with FDG-avid primary, recurrent or metastatic cancer underwent a tumor excision, utilizing IV FDG and PET probe survey. Adequate tissue for diagnosis was present in 16 of 17 resected specimens, and pathology was positive for malignancy in 12 of the 17 FDG-avid lesions. PET probe gamma counts per second were higher in tumors compared with adjacent benign tissue in all operations. The median ex vivo tumor-to-background ratio (TBR) was 4.0 (range 0.9-12). The PET probe confirmed the excision of occult FDG-avid tumors in eight pediatric patients.

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References

Heij H, Rutgers E, de Kraker J, Vos A . Intraoperative search for neuroblastoma by MIBG and radioguided surgery with the gamma detector. Med Pediatr Oncol. 1997; 28(3):171-4. DOI: 10.1002/(sici)1096-911x(199703)28:3<171::aid-mpo2>3.0.co;2-g. View

Kurita T, Taruno K, Nakamura S, Takei H, Enokido K, Kuwayama T . Magnetically Guided Localization Using a Guiding-Marker System and a Handheld Magnetic Probe for Nonpalpable Breast Lesions: A Multicenter Feasibility Study in Japan. Cancers (Basel). 2021; 13(12). PMC: 8230842. DOI: 10.3390/cancers13122923. View

Newton A, Predina J, Corbett C, Frenzel-Sulyok L, Xia L, Petersson E . Optimization of Second Window Indocyanine Green for Intraoperative Near-Infrared Imaging of Thoracic Malignancy. J Am Coll Surg. 2018; 228(2):188-197. PMC: 6348120. DOI: 10.1016/j.jamcollsurg.2018.11.003. View

Song H, Guja K, Iagaru A . F-FDG PET/CT for Evaluation of Post-Transplant Lymphoproliferative Disorder (PTLD). Semin Nucl Med. 2021; 51(4):392-403. DOI: 10.1053/j.semnuclmed.2020.12.009. View

Sunderland J, Christian P . Quantitative PET/CT scanner performance characterization based upon the society of nuclear medicine and molecular imaging clinical trials network oncology clinical simulator phantom. J Nucl Med. 2014; 56(1):145-52. DOI: 10.2967/jnumed.114.148056. View

Cohn D, Hall N, Povoski S, Seamon L, Farrar W, Martin Jr E . Novel perioperative imaging with 18F-FDG PET/CT and intraoperative 18F-FDG detection using a handheld gamma probe in recurrent ovarian cancer. Gynecol Oncol. 2008; 110(2):152-7. DOI: 10.1016/j.ygyno.2008.04.026. View

Predina J, Newton A, Keating J, Dunbar A, Connolly C, Baldassari M . A Phase I Clinical Trial of Targeted Intraoperative Molecular Imaging for Pulmonary Adenocarcinomas. Ann Thorac Surg. 2018; 105(3):901-908. PMC: 10959252. DOI: 10.1016/j.athoracsur.2017.08.062. View

Zervos E, Desai D, DePalatis L, Soble D, Martin E . 18F-labeled fluorodeoxyglucose positron emission tomography-guided surgery for recurrent colorectal cancer: a feasibility study. J Surg Res. 2001; 97(1):9-13. DOI: 10.1006/jsre.2001.6092. View

Yasuda S, Makuuchi H, Fujii H, Nakasaki H, Mukai M, Sadahiro S . Evaluation of a surgical gamma probe for detection of 18F-FDG. Tokai J Exp Clin Med. 2001; 25(3):93-9. View

10.

Hall N, Povoski S, Murrey D, Knopp M, Martin Jr E . Combined approach of perioperative 18F-FDG PET/CT imaging and intraoperative 18F-FDG handheld gamma probe detection for tumor localization and verification of complete tumor resection in breast cancer. World J Surg Oncol. 2007; 5:143. PMC: 2235860. DOI: 10.1186/1477-7819-5-143. View

11.

Blanco J, Javier G, Fraile M, Isnard R, Castellvi A, Lopez P . [Radio-guided surgery with MIBG in a case of abdominal neuroblastoma]. Cir Pediatr. 1999; 12(3):127-8. View

12.

van Keulen S, Nishio N, Fakurnejad S, van den Berg N, Lu G, Birkeland A . Intraoperative Tumor Assessment Using Real-Time Molecular Imaging in Head and Neck Cancer Patients. J Am Coll Surg. 2019; 229(6):560-567.e1. DOI: 10.1016/j.jamcollsurg.2019.09.007. View

13.

Aalbersberg E, Verwoerd D, Mylvaganan-Young C, de Barros H, van Leeuwen P, Sonneborn-Bols M . Occupational Radiation Exposure of Radiopharmacy, Nuclear Medicine, and Surgical Personnel During Use of [Tc]Tc-PSMA-I&S for Prostate Cancer Surgery. J Nucl Med Technol. 2021; 49(4):334-338. DOI: 10.2967/jnmt.121.262161. View

14.

Kostakoglu L, Agress Jr H, Goldsmith S . Clinical role of FDG PET in evaluation of cancer patients. Radiographics. 2003; 23(2):315-40; quiz 533. DOI: 10.1148/rg.232025705. View

15.

Martelli H, Ricard M, Larroquet M, Wioland M, Paraf F, Fabre M . Intraoperative localization of neuroblastoma in children with 123I- or 125I-radiolabeled metaiodobenzylguanidine. Surgery. 1998; 123(1):51-7. View

16.

Sun D, Bloomston M, Hinkle G, Al-Saif O, Hall N, Povoski S . Radioimmunoguided surgery (RIGS), PET/CT image-guided surgery, and fluorescence image-guided surgery: past, present, and future. J Surg Oncol. 2007; 96(4):297-308. DOI: 10.1002/jso.20869. View

17.

Povoski S, Hall N, Murrey Jr D, Wright C, Martin Jr E . Feasibility of a multimodal (18)F-FDG-directed lymph node surgical excisional biopsy approach for appropriate diagnostic tissue sampling in patients with suspected lymphoma. BMC Cancer. 2015; 15:378. PMC: 4426183. DOI: 10.1186/s12885-015-1381-z. View

18.

Leide-Svegborn S . Radiation exposure of patients and personnel from a PET/CT procedure with 18F-FDG. Radiat Prot Dosimetry. 2010; 139(1-3):208-13. DOI: 10.1093/rpd/ncq026. View

19.

Randall L, Wenham R, Low P, Dowdy S, Tanyi J . A phase II, multicenter, open-label trial of OTL38 injection for the intra-operative imaging of folate receptor-alpha positive ovarian cancer. Gynecol Oncol. 2019; 155(1):63-68. DOI: 10.1016/j.ygyno.2019.07.010. View

20.

Chambers G, Frood R, Patel C, Scarsbrook A . F-FDG PET-CT in paediatric oncology: established and emerging applications. Br J Radiol. 2018; 92(1094):20180584. PMC: 6404840. DOI: 10.1259/bjr.20180584. View