A Mini-Camera For The Treatment Of The Breast Cancers

By Abu Murad
With the interface between cancerology and physics, the current technological projections to improve the assumption of responsibility of cancers rest primarily on the development of new physical methods for tracking, the diagnosis and the clinical therapy. Among those, the techniques of medical imagery based on the use of radioactive tumor tracers make important great strides thanks to the development of new and specific molecules. Beyond the instrumentation, this multi-field research extends to the clinical aspect and aims at establishing a methodology adapted in order to evaluate the advantage of the apparatus on patient. It is in this context that researchers of laboratory IMNC set up an interdisciplinary group of research with doctors of the hospital Tenon (Paris) whose work allowed the development of a hospital Program for clinical research (PHRC), national program which tallies the clinical evaluation of imager POCI on 200 patients.
POCI, a new device of medical imagery-
Within the framework of the surgical treatment of cancer, probes acting as of the meters of radioactivity were introduced in operating theatre suite to assist the surgeon in real time during the ablation of the beforehand radio-marked tumors. This technique of radio guidance gives access the precise localization and the complete ablation of tumor fabrics. It is to reinforce this technique that the team “Imagery and Modeling in Cancerology” of the IMNC undertook the development of a new generation of gamma-camera miniaturized for the assistance with the chirurgical treatment of cancer called POCI. It is about a particularly innovative application of the instrumental developments used in fundamental physics. With 13 cm2 of fields of sight and reduced dimensions , this imager was designed to be easily positioned in contact with the operational wound in order to locate the tumor lesions radio-marked during the surgical operation .
Imager POCI is currently evaluated via the protocol of the “ganglion sentinel” within the framework of the breast cancers. In practice, this last is detected thanks to the injection of a radioactive solution around the tumor. A lymphoscintigraphy then makes it possible to count the ganglia and to obtain their precise localization. Lastly, the biopsy is traditionally carried out in operating theatre suite using the probe meter of radioactivity which makes it possible to the surgeon to check the position of the “ganglion sentinel” before the incision, to identify it in the operational wound and finally, after excision, to confirm the absence of any residual radioactivity.
The clinical evaluation of camera POCI associating for the first time of the researchers of in2P3-CNRS and the AP-HP rests on a double study: to prove its equivalence compared to the gamma-cameras standards and to establish its interest in operating theatre suite in order to identify the “ganglia sentinels” not detected by the probe. Begun in January 2006 with the agreement from the Consultative Committee from protection from the people in biomedical research (CCPPRB) and that from the French Agency from medical safety from the products from health (AFSSAPS), this clinical study includes 200 patients. After examination of a hundred patients with camera POCI as well in service of nuclear medicine as in operating theatre suite, the first results are extremely encouraging.
Several groups of research, in particular in North America, in Japan and in Italy, were directed towards the development of portable gamma-cameras specifically dedicated to per-operational detection. It is in this context of strong international competition that the team of the IMNC remains the only one today to have evaluated, in operating theatre suite and on a significant number of patients, a system of imagery miniaturized for the assistance with the surgical treatment of cancer.