Intraoperative detection and resection of occult neuroblastoma: A technique exploiting somatostatin receptor expression

Aggressive surgical therapy and radiotherapy for patients with high-risk neuroblastoma treated with rapid sequence tandem transplant

“…Although findings on the postoperative studies likely indicated additional residual tumor, the findings could be confused by scar tissue or bpostoperative changesQ that did not represent actual tumor. Increased use of radionucleotide labeling studies (MIBG) and the development and implementation of previously described intraoperative scanning techniques [19,20] may help to answer this question more definitively in future studies. However, the lack of correlation between different modes of assessing residual tumor makes interpretation of data regarding the importance of complete versus near-complete resection difficult to interpret in this and other studies.…”

Growing vascular endothelial cells express somatostatin subtype 2 receptors

“…Based on these observations, it appears that similar receptors and post-receptor signal transduction pathways are responsible for somatostatin's ability to inhibit peptide release, tumour growth, and angiogenesis (Bhatena et al, 1981;Thompson et al, 1986;Woltering et al, 1986;Wynick and Bloom, 1991). The widespread use of radiolabelled somatostatin analogues in patients with neuroendocrine tumours has demonstrated that these sst 2-containing tumours avidly bind radiolabelled sst 2-preferring somatostatin analogues such as tyr 3 -octreotide, lanreotide, and pentetreotide (Schirmer et al, 1993;Woltering et al, 1994;Martinez et al, 1995;Woltering et al, 1995;McCarthy et al, 1998;Cuntz et al, 1999;Espenan et al, 1999). Inevitably, as larger numbers of tumour-bearing patients have been scanned with these radiolabelled analogues, tissues and organs subjected to nontumour disease processes have been shown to bind these radioligands.…”

“…This difference in receptor expression may permit the use of low energy radioisotopes for therapy (McCarthy et al, 1998;Espenan et al, 1999). Sst 2-targeted applications may include intraoperative gamma localization of occult primary tumours, and intraoperative gamma detection of microscopically positive primary tumour resection margins (Schirmer et al, 1993;Woltering et al, 1994;Martinez et al, 1995;Cuntz et al, 1999). This sensitive technique may also allow the detection of small deposits of tumour in lymph nodes or in areas outside the normal field of resection .…”

Scintigraphic Imaging of Sarcomatous Tumors with [¹¹¹In-DTPA-Phe-1]-Octreotide

“…Intraoperatively, the use of this technique serves not only to detect occult foci but is also useful to demarcate the resection margins of the tumors, thus decreasing the possibility of residual disease while simultaneously minimizing the excessive removal of surrounding healthy tissues [39]. Regarding the indications for radioimmunoguided surgery, the first reports are encouraging [40, 41, 42]. A significant advantage is that 111 In-octreotide uptake by sarcomatous lesions may be attributed to the expression of somatostatin receptors on these tumors and is not due to nonspecific uptake as is observed with other radiopharmaceuticals.…”