@misc{oai:repo.qst.go.jp:00066291,
 author = {田島, 英朗 and 吉井, 幸恵 and 岩男, 悠真 and 吉田, 英治 and 脇坂, 秀克 and 田桑, 弘之 and 須尭, 綾 and 張, 明栄 and 山谷, 泰賀 and Tashima, Hideaki and Yoshii, Yukie and Iwao, Yuma and Yoshida, Eiji and Wakizaka, Hidekatsu and Takuwa, Hiroyuki and Sugyo, Aya and Ming-Rong, Zhang and Yamaya, Taiga},
 month = {Apr},
 note = {1. Introduction
Surgical operations are performed as the standard treatment for various types of cancers. However, it is challenging to remove all the tumors in one surgery if the tumors are widely and complexly distributed and they move with the organs or they are located on the backside of the organs. On the other hand, we are developing the OpenPET, which can provide accessible open space to the patient during PET scanning. In this study, we applied the open space for the image-guided surgery by the real-time OpenPET imaging. For a proof of concept, we developed a small prototype and conducted actual surgery to remove cancer tumors from a mouse.

2. Materials and Methods
The proposed system was implemented on a small prototype of a single-ring OpenPET, which has the shape of a cylinder cut by two slanted parallel planes to form an open space. For real-time image reconstruction, we implemented the 3D DRAMA on the GPU. Human colon carcinoma HCT116-RFP cells had been intraperitoneally transplanted into a mouse. Twenty-four hours after intraperitoneal injection of anti-EGFR antibody cetuximab labeled with 64Cu, the mouse was set onto the operation table inside the FOV of the OpenPET for an abdominal operation.

3. Results and Discussion
At first, we checked the tumor locations by the OpenPET imaging when the mouse was set on an operation stage. Measurement time required to acquire sufficient data to visually identify the tumors with clear contrast was about 10-30 s. Images were reconstructed with less than 1 s, and displayed images became gradually clearer every second. After removing the tumors and placing them outside the body, we could confirm by PET images that the tumors with radioactivity concentration had been appropriately resected.

4. Conclusion
The surgery demonstrated that the system allowed us to confirm tumor positions anytime during the operation. The proposed system was effective in preventing any tumors, especially those located behind organs, from being left after the surgery., The 113th Scientific Meeting of the Japan Society of Medical Physics},
 title = {Development of a small prototype system toward real-time OpenPET image-guided surgery},
 year = {2017}
}