Quantitative assessment of Cerenkov luminescence for radioguided brain tumor resection surgery

Abstract

Cerenkov luminescence imaging (CLI) is a developing imaging modality that detects radiolabeled molecules via visible light emitted during the radioactive decay process. We used a Monte Carlo based computer simulation to quantitatively investigate CLI compared to direct detection of the ionizing radiation itself as an intraoperative imaging tool for assessment of brain tumor margins. Our brain tumor model consisted of a 1 mm spherical tumor remnant embedded up to 5 mm in depth below the surface of normal brain tissue. Tumor to background contrast ranging from 2:1 to 10:1 were considered. We quantified all decay signals (e+/−, gamma photon, Cerenkov photons) reaching the brain volume surface. CLI proved to be the most sensitive method for detecting the tumor volume in both imaging and non-imaging strategies as assessed by contrast-to-noise ratio and by receiver operating characteristic output of a channelized Hotelling observer.

Radioluminescence in biomedicine: physics, applications, and models

“…CLI of injected radiopharmaceuticals (e.g. 18 F-fluorodeoxyglucose, FDG) is also being explored to guide surgeries such as sentinel lymph node biopsy, tumor margin assessment, and tumor detection; its potential utility is supported by both theoretical (Klein et al 2017) and experimental evidence (Thorek et al 2014b, Hu et al 2015, Grootendorst et al 2016b. Though briefly covered below, a comprehensive review has been written on the clinical applications of CLI (Grootendorst et al 2016a).…”

Performance evaluation of the LightPath imaging system for intra-operative Cerenkov luminescence imaging

“…CLI images have been acquired in neurosurgery [9] and in breast-conserving surgery [10]. The potential application to brain tumor radio-guided resection has been further investigated with Monte Carlo simulations [11].…”

Inorganic Nanoparticles as Radiosensitizers for Cancer Treatment

“…An emerging application of radiation is utilizing Cerenkov radiation from radionuclides and radiotherapy for optical imaging purposes [63]. Conjugating Cerenkov luminescence imaging (CLI) with radiopharmaceuticals, such as F-fluorodeoxyglucose, holds great potential to supplement sentinel node biopsies, monitoring tumor growths, and tumor imaging [64][65][66][67]. CLI is comparable in function to Positron Emission Tomography (PET) scans [63].…”

“…Additionally, CLI is an effective radiotracer for breast cancer and gastrointestinal tract (GI) tumors. Cancer phototherapy integrates photosensitizers for cancer phototherapy [64,65]. Photosensitizers are drugs that are activated when presented with a light stimulus [64].…”