Radioguided surgery with gallium for neuroendocrine tumors
Menée auprès de 44 patients (âge moyen : 51 ans) atteints d'une tumeur neuroendocrine (pancréatique, gastro-intestinale, phéochromocytome ou paragangliome), cette étude détermine les seuils de positivité permettant d'identifier et de circonscrire les lésions cancéreuses au cours d'une intervention chirurgicale radioguidée utilisant le gallium 68 associé à un peptide ciblant les récepteurs de la somatostatine
Radioisotopes have been used as an adjunct during surgery for the past few decades and have been especially useful in operations for breast cancer1 and melanoma.2 Technetium 99m–labeled sulfur colloid is injected intradermally and accumulates in the first regional lymph node draining that area, which is detected using a handheld gamma counter. Sentinel lymph node biopsy has proven valuable for staging patients, determining the need for adjuvant therapy, and, previously, selecting patients for lymphadenectomy. Radiopharmaceuticals given intravenously may also accumulate within tumors and aid in their localization. Fluorodeoxyglucose is taken up in rapidly metabolizing cells, and technetium 99 sestamibi is retained in mitochondria and has shown utility in radioguided surgery (RGS) for hyperparathyroidism.3 Neuroendocrine tumors (NETs) commonly express high levels of the somatostatin type 2 receptor, which has also been used as a target for radiopharmaceuticals.
JAMA Surgery , commentaire, 2017