放射引导手术（RGS）是一种通过术中检测与肿瘤细胞结合的放射示踪剂释放的微粒来帮助外科医生实现尽可能完整的肿瘤切除的技术。本研究旨在通过蒙特卡洛模拟，调查β-RGS技术在术前注射[18F]FDG的宫颈癌患者中用于肿瘤切除和切缘评估的适用性。病人如果患有复发或持续的宫颈癌，接受术前PET / CT以排除远处转移，并接受激进手术，即纳入了回顾性的分析。所有PET / CT图像都被分析，提取肿瘤SUVmax，背景SUVmean和肿瘤与非肿瘤比值。这些值被用于通过β探测器的蒙特卡洛模拟，假设术前注射2 MBq / kg的[18F]FDG，并在术前60分钟进行手术时模拟手术环境中的预期计数率。共包括38名患者。在给定的病变中，预计测量时间约为2-3秒，足以区分肿瘤与背景，这是探测器必须悬停在样本上能够以约99%的敏感性和至少95%的特异性区分肿瘤和健康组织的时间。本研究首次探索了将β-RGS技术应用于宫颈癌的可能性的第一步。结果表明，即使在高放射示踪剂背景活性的情况下，这种β-RGS方法可以帮助外科医生区分肿瘤边缘与周围健康组织。版权所有 © 2023 Elsevier Ltd. 发布。

Radioguided surgery (RGS) is a technique that helps the surgeon to achieve a tumour resection as complete as possible, by means of the intraoperative detection of particles emitted by a radiotracer that bounds to tumoural cells. This study aimed to investigate the applicability of β-RGS for tumour resection and margin assessment in cervical cancer patients preoperatively injected with [18F]FDG, by means of Monte Carlo simulations.Patients were retrospectively included if they had a recurrent or persistent cervical cancer, underwent preoperative PET/CT to exclude distant metastases and received radical surgery. All PET/CT images were analysed extracting tumour SUVmax, background SUVmean and tumour-to-non-tumour ratio. These values were used to obtain the expected count rate in a realistic surgical scenario by means of a Monte Carlo simulation of the β probe, assuming the injection of 2 MBq/kg of [18F]FDG 60 min before surgery.Thirty-eight patients were included. A measuring time of ∼2-3 s is expected to be sufficient for discriminating the tumour from background in a given lesion, being this the time the probe has to be over the sample in order to be able to discriminate tumour from healthy tissue with a sensitivity of ∼99% and a specificity of at least 95%.This study presents the first step towards a possible application of our β-RGS technique in cervical cancer. Results suggest that this approach to β-RGS could help surgeons distinguish tumour margins from surrounding healthy tissue, even in a setting of high radiotracer background activity.Copyright © 2023. Published by Elsevier Ltd.