Nuclear Science Symposium
and
Medical Imaging Conference

Lyon, France
October
15-20, 2000

WORKSHOP: Clinical impact of intraoperative probes
for radioguided operative cancer surgery :
state of the art et future prospects

Tuesday 17th October 2000 from 13:00 to 15:30 pm

Chairmen : J.N. Aarsvold, Y. Charon
Organizers : S.A. Larsson, Y. Charon

Aim :

To assess and discuss the interest and effectiveness of intraoperative probes (both single pixel and imagers) on a clinical point of view and to identify major trends for the next future.

Introduction :

Although the use of probes for detecting radiolabeled tumours is far from new, recent improvements on both tracers specificity and nuclear instrumentation give rise to new prospects for radio guided operative cancer surgery (RGOCS). Beside the clinical success of single pixel detector for tumor excision, several prototypes of imaging probes are currently under development. Beyond the instrumental considerations, time is coming to join the theater block and discuss the clinical impact of such probes for cancer surgery and for oncology. This is the aim of the workshop which will also provide the opportunity to introduce the key features of RGCOS and to identify the major trends of this medical field for the next future.

Program : it contains three parts and a final discussion

I - The clinical context : 30 minutes - Pr. Alan Perkins (Nottingham Queen's medical centre)
Contents : Introduction to the key features of guided operative cancer surgery :
a - nature, history and stakes
b - range of tumours types and labeling agents
b - preoperative, intraoperative et post operative detection
c – overview of the current detection techniques currently
implemented :
blue dyes, gamma and beta counters and imagers (MNR ?,
ultra-sounds ?)

II - The clinical interest of RGOCS : the example of Sentinel Node
detection

1 - The surgeon point of view : 15 ‘ talk + 5 ‘ : Pr. David Krag (Univ. of Vermont)
Presentation of SN protocol, state of the art of the technique, sanitary impact of RGCOS

2 - The single-pixel probes and the imaging probes : 25 ‘ talk + 5 ‘ : Dr. Marcel Ricard (IGRVillejuif)
single pixel probes : characteristics, performances, clinical assessment and limits
imaging probes : characteristics, performances, clinical assessment and limits

III - Synthesis and conclusion : introduction to the discussion : 30 ' : Pr. David Krag

- Stock of the situation : effectiveness and limiting factors of the RGOCS technique…
- Future prospects : range of pathological conditions to be cured in the next future thanks to new intraoperative protocols

IV - Discussion : round table : 40 ' : Pr. Aarsvold, Pr. Charon, Pr.Kragg, Pr. Perkins, Dr. Ricard

questions to address :
- what is the clinical impact of imaging probes when compared to single pixel probes ?
- what kind of protocol taking advantage of RGCOS do surgeons expect for the near future ?
- how to improve current gamma-probes in order to fit surgeon requirements ?
- which other research field of oncology can take advantage of high resolution small FOV hand-held gamma cameras : small animal in vivo imaging (biodistributions…), diagnosis, therapy monitoring…