1. An intra-operative beta probe for brain tumor surgery Interfaces Physique Biologie group, University of Paris XI S. Bonzom, L. Ménard, M.A Duval, S. Pitre, L. Blanc R. Siebert, Y. Charon Neurosurgery group of the Henri Mondor hospital (Créteil) S. Palfi PSD7 Liverpool – 1

2. Treatments of brain tumors 40 % of adult brain tumors are glioma (5 to 10/100 000 cases each year) Gliomas have high diffusion and proliferation capabilities High-grade gliomas have a poor vital pronostic (survival under 1 year) Surgery is still the more efficient treatment Current medical imaging systems aren’t sensitive enough to detect the entire extent of the tumor Development of new intraoperative systems to help in real time the surgeon during the excision PSD7 Liverpool – 2

3. Two complementary families of intraoperative detectors New miniaturized tools dedicated to cancer surgery Standard imaging systems adapted to the surgical room (ultrasound, scanner, low-field MRI) Systems using a pharmaceutical tracer (labelled with radioactivity or fluorescence) coupled to a miniaturized detection probe. PSD7 Liverpool – 3

4. Instrumentals constraints imposed by the detection of brain tumors Very high sensitivity (detection of tumor edges) Compactness (small operative wound) Gamma background noise discrimination Correlation between the image and the real position of the tumor Development of an intraoperative probe dedicated to the detection of   Development of an intraoperative probe dedicated to the detection of   particles and built around plastic scintillating fibers. PSD7 Liverpool – 4

5. Optic fiber  -sensitive fiber Resistive network Detection head Clear optical fiber bundle  -shielded fiber External detection and acquisition module Multi anode photomultiplier Principle of the beta intraoperative probe PSD7 Liverpool – 5

6. Geometrical phantom Voxelised anthropomorphic phantom (Mc Gill University) Numerical phantoms Optimization of the detector geometry by Monte Carlo simulations (MCNP 4C) PSD7 Liverpool – 6

7. Radioactif tracers SUV= Standard Uptake Value SUVTumorSUV White matter SUVCortex 18 F-FDG 5.23.33.7 18 F-FET 2.50.650.9 18 F-Choline 1.50.150.15 of the detector geometry by Monte Carlo simulations (MCNP 4C) Optimization of the detector geometry by Monte Carlo simulations (MCNP 4C) PSD7 Liverpool – 7

8. Detector geometry Brain Tumor edges Surgical cavity  sensitive fiber  shielded fiber Optimization of the detector geometry by Monte Carlo simulations (MCNP 4C) PSD7 Liverpool – 8

9. Gamma background noise characterization 18 F-FDG 18 F-Choline Optimization of the detector geometry by Monte Carlo simulations (MCNP 4C) PSD7 Liverpool – 9

10.  -sensitive fiber Choice of a 2mm diameter and 0.5mm length  -sensitive fiber Optimization of the detector geometry by Monte Carlo simulations (MCNP 4C) PSD7 Liverpool – 10

11. Optimization of the detector geometry by Monte Carlo simulations (MCNP 4C)  -shielded fiber Choice of a 2mm length  -shielded fiber PSD7 Liverpool – 11

12. Expected theoretical performances Overall  sensitivity of 72cps/  Ci/ml Sensitivity volume of 48 ml Gamma ray discrimination efficiency of 99.6 % for 18 F-FET Minimum detectable radiotracer concentration: Radiotracer Minimum detectable concentration (  Ci/ml) Bulk tumor concentration (  Ci/ml) 18 F-FDG0.350.59 18 F-FET0.100.29 18 F-Choline0.040.17 PSD7 Liverpool – 12

13. Prospects PSD7 Liverpool – 13

14. Thank you for your attention !