Specimen-PET/CT-Scanner

• Subject Area: Medicine
• Term: Funded in 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 537697828

Radioguided surgery (RGS) is a nuclear medicine discipline that offer a range of innovative technologies to support healthcare interventions. PET imaging, which uses beta-plus-emitting radionuclides, is rapidly advancing the field of molecular imaging, leading to the widespread clinical availability of diagnostic tracers. RGS using tracers specifically binding to tumor tissues can provide surgeons with valuable clinical information that provide patients with better surgical outcomes. The prevention of positive surgical margins (PSM) in organ-sparing resection procedures is crucial as unfavorable PSM may increase the risk of developing metastases and require additional postoperative radiotherapy. This can negatively impact the oncological outcome and affect the patient's quality of life. Currently the gold standard for the prediction of PSM is the use of intraoperative frozen section analysis (IFS), which can help the surgeon to preserve functional structures like the neurovascular bundles. However, besides resource consumption, there is also some conflicting evidence, as studies demonstrated high false-negative rates of IFS, potentially resulting in unjustified nerve-sparing surgery. Intraoperative imaging and RGS allow for evaluation of the entire surface of the tumor-bearing tissues, such as prostate or metastases, instead of only specific IFS slices. Intraoperative beta-plus-emitting probes for surgery include hand-held plastic scintillators, light tight chambers with sensitive light detectors, and specimen-PET/CT devices. Each modality has advantages and challenges. Specimen-PET/CT (or small animal PET/CT scanners) are designed to detect 511 keV photons resulting from beta-particle annihilation in tissue, thereby providing three-dimensional tracer distribution maps. If combined with a micro-computer tomography scanner, the device could provide full anatomical coverage of the specimen to image. Small animal PET devices normally possess a trans-axial field of view of about 10 cm, being able to cover most specimens in one scan. The physics and image interpretation of PET/CT are well known for scientists working in nuclear medicine. This accentuates the potential for standardized imaging techniques, that can deliver reproducible and accurate scan reading, which translate in better patient care for patients undergoing tissue sparing oncological surgery. The workgroup proposes the use of a specimen-PET/CT device for molecular imaging guided surgery in the oncological domain. Primarily for the use in prostatectomy in the detection of PSM and positive lymph nodes, with the main goal of increasing the precision of surgical procedures and improve patient care. Basic research studies with a strong data-science / physics component will be developed to strengthen the standardization of PET/CT findings.

• DFG Programme: Major Research Instrumentation
• Major Instrumentation: Proben-PET/CT-Scanner
• Instrumentation Group: 3321 Positronen-Emissionstomographen (PET)
• Applicant Institution: Universität Duisburg-Essen
• Leader: Professor Dr. Ken Herrmann