Feasibility study on the implementation of a mobile high-resolution PET/CT scanner for surgical specimens: exploring clinical applications and practical considerations

IF 7.6 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Journal of Nuclear Medicine and Molecular Imaging Pub Date : 2025-02-20 DOI:10.1007/s00259-025-07143-z

Bieke Lambert, Valérie Vergucht, Sam Dekeyser, Annick De Craene, Filip Ameye, Bieke Van Den Bossche, Dieter Berwouts, Jeroen Mertens, Henk Vanoverschelde, Mieke Coppens, Charlotte Gabriel, Marianne Rottiers, Carole Van Haverbeke, Peter Dekuyper, Pieter De Backer, Kenneth Carels, Tessa Van Oostveldt, Karel Decaestecker

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Abstract

Purpose

In this trial we explore potential indications of an intra-operative mobile PET/CT camera. The tested device is designed to acquire high quality images of resected tissue specimens from patients who were administered a PET-tracer, shortly before resection. Besides clinical experiences, we will also comment on the practical aspects of the implementation of a safe workflow for intra-operative PET/CT-imaging.

Methods

This investigator driven study involved a 12-month evaluation of the AURA 10 PET/CT camera (XEOS Medical, Belgium). Depending on the tumour type, [¹⁸F]FDG, [18F]JK-PSMA-7, [^18F]PSMA-1007 or [¹⁸F]Choline was injected intravenously 60–90 min prior to the removal of the tumour. The tissue was scanned in the mobile PET/CT-device and 12 min later the surgeon could review the images. Specimen PET/CT-images were confronted with pathology findings. Dose rates were monitored around the patient throughout the procedure.

Results

The technique was tested in 32 surgeries for thyroid carcinomas (n = 5), transitional cell carcinomas (n = 2,) renal cell carcinoma (n = 1), prostate cancer (n = 5), breast carcinoma (n = 7), skin cancer (n = 3), nodal or bone biopsy for oncology work up (n = 6) and parathyroid adenoma (n = 3). Normalized to an injected activity of 1 MBq/kg the estimated median absorbed doses per procedure were 15.6 µSv (range 0,7-140,8) and 14,1 µSv (0,5–46,2) for respectively the surgeons and instrumenting nurses.

Conclusion

The overall experience of intra-operative PET/CT-imaging of surgical specimens was promising in our hospital, with particular added value in case of (para)thyroid, urological surgeries, and oncological work-ups. High quality images were obtained with low activity of tracers, enabling a safe implementation.

Trial registration number (Belgium)

BUN: B0172022000009 (NCT retrospectively submitted).

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应用移动高分辨率PET/CT扫描外科标本的可行性研究：探讨临床应用和实际考虑

目的在本试验中，我们探讨术中移动PET/CT相机的潜在适应症。所测试的设备旨在获得切除组织标本的高质量图像，这些患者在切除前不久接受了pet示踪剂。除了临床经验外，我们还将评论术中PET/ ct成像安全工作流程的实施的实际方面。方法本研究由研究者主导，对AURA 10 PET/CT相机（XEOS Medical，比利时）进行了为期12个月的评估。根据肿瘤类型，在肿瘤切除前60-90分钟静脉注射[18F]FDG、[18F]JK-PSMA-7、[18F]PSMA-1007或[18F]胆碱。在移动PET/ ct设备中扫描组织，12分钟后外科医生可以查看图像。标本PET/ ct图像与病理结果相对照。在整个过程中监测患者周围的剂量率。结果32例甲状腺癌（n = 5）、移行细胞癌（n = 2）、肾细胞癌（n = 1）、前列腺癌（n = 5）、乳腺癌（n = 7）、皮肤癌（n = 3）、肿瘤淋巴结或骨活检（n = 6）和甲状旁腺瘤（n = 3）的手术中应用了该技术。按注射活度1 MBq/kg归一化后，外科医生和器械护士每次手术的估计中位吸收剂量分别为15.6µSv（范围0.7 -140,8）和14.1µSv（范围0.5 - 46,2）。结论我院术中手术标本PET/ ct成像总体经验丰富，对甲状腺（副）、泌尿外科及肿瘤检查具有特殊的附加价值。以低活性示踪剂获得高质量图像，使其安全实施。试验注册号（比利时）BUN: B0172022000009 （NCT回顾性提交）。

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来源期刊

European Journal of Nuclear Medicine and Molecular Imaging 医学-核医学

CiteScore

15.60

自引率

9.90%

发文量

392

审稿时长

3 months

期刊介绍： The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.