Explore the vast range of titles available.

The background induced by the high penetration power of the radiation is the main limiting factor of the current radio-guided surgery (RGS). To partially mitigate it, a RGS with β + -emitting radio-tracers has been suggested in literature. Here we propose the use of β − -emitting radio-tracers and β − probes and discuss the advantage of this method with respect to the previously explored ones: the electron low penetration power allows for simple and versatile probes and could extend RGS to tumours for which background originating from nearby healthy tissue makes probes less effective. We developed a β − probe prototype and studied its performances on phantoms. By means of a detailed simulation we have also extrapolated the results to estimate the performances in a realistic case of meningioma, pathology which is going to be our first in-vivo test case. A good sensitivity to residuals down to 0.1 ml can be reached within 1 s with an administered activity smaller than those for PET-scans thus making the radiation exposure to medical personnel negligible.

IntroductionThe treatment of the flexor tendon adhesions following phalanx and metacarpal fractures, in closed or open injuries, is a great challenge for the hand surgeon. The outcomes are often poor, because of the severity of the lesion and the aggressiveness of the surgical procedure of the secondary tenolysis.Materials and methodsThe authors describe the technical findings and the results of a new mini-invasive tenolysis in order to treat the adhesions in zone 1 and 2 of the fingers, following phalangeal and metacarpal fractures. With an atraumatic Allis or Duval surgical forceps, the flexor tendons are separately and gently tracted making a twisting movement on themselves until the adhesions were torn and the tendons appeared released.ResultsThe relevant outcomes achieved show this technique is very useful to treat tendon adhesions, without adding trauma and scare to the tendinous canal and surrounding soft tissues.

A radio-guided surgery technique exploiting β− emitters is under development. It aims at a higher target-to-background activity ratio implying both a smaller radiopharmaceutical activity and the possibility of extending the technique to cases with a large uptake of surrounding healthy organs. Such technique requires a dedicated intraoperative probe detecting β- radiation. A first prototype has been developed relying on the low density and high light yield of the diphenylbutadiene doped para-therphenyl organic scintillator. The scintillation light produced in a cylindrical crystal, 5 mm in diameter and 3 mm in height, is guided to a photo-multiplier tube by optical fibres. The custom readout electronics is designed to optimize its usage in terms of feedback to the surgeon, portability and remote monitoring of the signal. Tests show that with a radiotracer activity comparable to those administered for diagnostic purposes the developed probe can detect a 0.1 ml cancerous residual of meningioma in a few seconds.

Particle therapy is a technique that uses accelerated charged ions for cancer treatment and combines a high irradiation precision with a high biological effectiveness in killing tumor cells [1]. Informations about the secondary particles emitted in the interaction of an ion beam with the patient during a treatment can be of great interest in order to monitor the dose deposition. For this purpose an experiment at the HIT (Heidelberg Ion-Beam Therapy Center) beam facility has been performed in order to measure fluxes and emission profiles of secondary particles produced in the interaction of therapeutic beams with a PMMA target. In this contribution some preliminary results about the emission profiles and the energy spectra of the detected secondaries will be presented.

Finding new ways to fight cancer is essential to increase the patients life expectancy. This paper reports the latest results of the project CHIRONE finalized to increase the potential of the Radio Guided Surgery through the use of β− emitting radio-tracers and β− probes. This innovation could overcome the present main limiting factor represented by a diffuse background due to the high penetration power of the gamma radiation used. We created a prototype of β− probe and in this paper we report measures of photon efficiency, acquired with commercial photons sources. Then we estimated the signal and background rates in realistic cases of meningioma through a simulation. The device is able to detect residuals of 0.1 ml in 1 s with an administered activity less than 3 MBq/kg.

Purpose: A radio-guided surgery technique with beta- -emitting radio-tracers was suggested to overcome the effect of the large penetration of gamma radiation. The feasibility studies in the case of brain tumors and abdominal neuro-endocrine tumors were based on simulations starting from PET images with several underlying assumptions. This paper reports, as proof-of-principle of this technique, an ex-vivo test on a meningioma patient. This test allowed to validate the whole chain, from the evaluation of the SUV of the tumor, to the assumptions on the bio-distribution and the signal detection. Methods: A patient affected by meningioma was administered 300 MBq of 90Y-DOTATOC. Several samples extracted from the meningioma and the nearby Dura Mater were analyzed with a beta- probe designed specifically for this radio-guided surgery technique. The observed signals were compared both with the evaluation from the histology and with the Monte Carlo simulation. Results: we obtained a large signal on the bulk tumor (105 cps) and a significant signal on residuals of \\(\\sim\\)0.2 ml (28 cps). We also show that simulations predict correctly the observed yields and this allows us to estimate that the healthy tissues would return negligible signals (~1 cps). This test also demonstrated that the exposure of the medical staff is negligible and that among the biological wastes only urine has a significant activity. Conclusions: This proof-of-principle test on a patient assessed that the technique is feasible with negligible background to medical personnel and confirmed that the expectations obtained with Monte Carlo simulations starting from diagnostic PET images are correct.

Monitoring the dose delivered during proton and carbon ion therapy is still a matter of research. Among the possible solutions, several exploit the measurement of the single photon emission from nuclear decays induced by the irradiation. To fully characterize such emission the detectors need development, since the energy spectrum spans the range above the MeV that is not traditionally used in medical applications. On the other hand, a deeper understanding of the reactions involving gamma production is needed in order to improve the physic models of Monte Carlo codes, relevant for an accurate prediction of the prompt-gamma energy spectrum.This paper describes a calibration technique tailored for the range of energy of interest and reanalyzes the data of the interaction of a 80MeV/u fully stripped carbon ion beam with a Poly-methyl methacrylate target. By adopting the FLUKA simulation with the appropriate calibration and resolution a significant improvement in the agreement between data and simulation is reported.

Organic scintillators are often chosen as radiation detectors for their fast decay time and their low Z, while inorganic ones are used when high light ields are required. In this paper we show that a para-terphenyl based detector has a blend of properties of the two categories that can be optimal for energy and position measurements of low energy charged particles. On 0.1% diphenylbutadiene doped para-terphenyl samples we measure a light yield 3.5+-0.2 times larger than a typical organic scintillator (EJ-200), and a rejection power for 660 keV photons, with respect to electrons of the same energy, ranging between 3-11%, depending on the signal threshold. We also measure a light attenuation length = 4.73+-0.06 mm and we demonstrate that, with the measurements performed in this paper, a simulation based on FLUKA can properly reproduce the measured spectra.

Nowadays there is a growing interest in Particle Therapy treatments exploiting light ion beams against tumors due to their enhanced Relative Biological Effectiveness and high space selectivity. In particular promising results are obtained by the use of \\(^4\\)He projectiles. Unlike the treatments performed using protons, the beam ions can undergo a fragmentation process when interacting with the atomic nuclei in the patient body. In this paper the results of measurements performed at the Heidelberg Ion-Beam Therapy center are reported. For the first time the absolute fluxes and the energy spectra of the fragments - protons, deuterons, and tritons - produced by \\(^4\\)He ion beams of 102, 125 and 145 MeV/u energies on a poly-methyl methacrylate target were evaluated at different angles. The obtained results are particularly relevant in view of the necessary optimization and review of the Treatment Planning Software being developed for clinical use of \\(^4\\)He beams in clinical routine and the relative benchmarking of Monte Carlo algorithm predictions.

Measurements performed with the purpose of characterizing the charged secondary radiation for dose release monitoring in particle therapy are reported. Charged secondary yields, energy spectra and emission profiles produced in poly-methyl methacrylate (PMMA) target by 4He and 12C beams of different therapeutic energies were measured at 60 and 90 degree with respect to the primary beam direction. The secondary yields of protons produced along the primary beam path in PMMA target were obtained. The energy spectra of charged secondaries were obtained from time-of-flight information, whereas the emission profiles were reconstructed exploiting tracking detector information. The measured charged secondary yields and emission profiles are in agreement with the results reported in literature and confirm the feasibility of ion beam therapy range monitoring using 12C ion beam. The feasibility of range monitoring using charged secondary particles is also suggested for 4He ion beam.