Page 11 - ITPS-6-2

INNOSC Theranostics and
Pharmacological Sciences Theranostics in neurosurgery

Table 1. Summary of studies assessing the clinical application of [ Ga] Ga‑DOTATOC‑PET as a diagnostic measure
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Study Participants enrolled Outcome
Milker-Zabel Twenty-six patients with [ Ga] Ga-DOTATOC-PET provided additional information about tumor
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et al., 2006 [34] meningioma diagnosed with [ Ga] extension that was otherwise not seen in imaging modalities, such as CT/MRI. It
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Ga-DOTATOC-PET also identified a tumor in 1 patient that was otherwise not visible on CT/MRI. The
researchers concluded that [ Ga] Ga-DOTATOC-PET improves target definition
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for intracranial meningiomas
Gehler Twenty-six patients with skull base [ Ga] Ga-DOTATOC-PET data provided additional information about the tumor
68
et al., 2009 [35] meningioma diagnosed with [ Ga] in 17 patients. There were major changes observed in clinical target volume in
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Ga-DOTATOC-PET 14 patients. The researchers concluded that [ Ga] Ga-DOTATOC-PET strongly
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complements CT/MRI data in cases of complex meningioma
Kowalski Nineteen patients with meningioma Utilizing [ Ga] Ga-DOTATOC-PET resulted in changes in clinical management
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et al., 2021 [36] diagnosed with MRI and [ Ga] for 3 patients. Maximum total lesion activity was better identified with [ Ga]
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68
Ga-DOTATOC-PET Ga-DOTATOC-PET, but meningioma volumes did not change significantly from
what was detected by MRI
Abbreviations: CT/MRI: Computed tomography/magnetic resonance imaging; PET: Positron emission tomography.
Table 2. Summary of studies evaluating the utility of Y‑DOTATOC in meningioma treatment
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Study Patients enrolled Outcome
Marincek et al., Thirty-four patients with progressive, Twenty-three patients achieved stable disease. Three patients experienced
2015 [37] unresectable meningioma treated with [ Lu] severe hematotoxicity, and one patient experienced severe renal toxicity.
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Lu-DOTATATE and Y-DOTATOC The study concluded that [ Lu] Lu-DOTATATE and Y-DOTATOC are
90
177
90
promising tools for treating progressive, unresectable meningioma
Gerster-Gilliéron Fifteen patients with recurrent or progressive 90 Y-DOTATOC is a promising second- or third-line treatment for
et al., 2015 [38] meningioma treated with Y-DOTATOC complex meningiomas
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Bartolomei et al., Twenty-nine patients with recurrent Nineteen patients achieved disease stabilization after 3 months, and
2009 [39] meningioma resistant to treatment treated with 10 experienced disease progression. Better results were seen in grade1
90 Y-DOTATOC; grade I (n=14), grade II (n=9), compared to higher grades, with a mean time to progression of 61
grade III (n=6) months compared to 13
Otte et al., Twenty-nine patients with advanced Twenty patients showed disease stabilization, with four showing a
1999 [40] SSTR-positive tumors treated with reduction of tumor mass and two showing partial remission. Three
90 Y-DOTATOC patients experienced disease progression. Five patients experienced
severe renal and/or hematotoxicity from the treatment. The study
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concluded that Y-DOTATOC is a promising therapy if issues of toxicity
can be resolved
Seystahl et al., Twenty patients with progressive meningioma 50% of patients reached stable disease after treatment with [ Lu]
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2016 [41] treated with [ Lu] Lu-DOTATATE; grade I Lu-DOTATATE. No statistically significant differences were observed
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(n=5), grade II (n=7), grade III (n=8) between grades
4. Automated pathology diagnosis in before proceeding with tissue resection. (ii) This is swiftly
neurosurgery followed by the preparation of the sample for histological
analysis. (iii) A pathological diagnosis is delivered to
The role of pathology within surgery has held invariable the operative team, including the neurosurgeon. (iv)
significance over time. This is particularly accurate in
neurosurgery with regard to the treatment of brain Ultimately, this diagnosis guides the intraoperative,
tumors . The final objective of neuro-oncological and consequently, the post-operative decisions of those
[49]
procedures is typically dependent on the extent of involved in the patient’s treatment. Treatment can exist in
tumorous tissue resection, which affects the level of cure the form of chemotherapy, radiotherapy, or further surgical
that can be provided. The intricacies of neuro-oncology intervention following proper post-operative appraisal
[50]
treatment following pathological analysis consist of several of the situation . The pipeline described within surgical
key events. To date, tumor resection for tissue analysis resection of neoplasms is often labeled as IOC, which is an
has followed a traditional pipeline: (i) intraoperatively, indispensable step within the operative sequence and has
tissue samples are acquired and sent to pathologic analysis granted theranostics a timely invitation.

Volume 6 Issue 2 (2023) 5 https://doi.org/10.36922/itps.417