Health
Serenkov Luminescent Imaging Identifies the Condition of Surgical Margins in Radical Prostatectomy-ScienceDaily
A new intraoperative imaging technique, the Cherenkov Emission Imaging (CLI), can accurately assess surgical margins during radical prostatectomy, according to a human experiment published in the October issue. Nuclear medicine journal.. Feasibility studies have shown that the 68Ga-PSMA CLI can image the entire surface of a resected prostate specimen to detect prostate cancer tissue at the resected margin.
Radical prostatectomy is one of the leading treatment options for men with localized prostate cancer. The goal of radical radical prostatectomy is to completely remove the prostate without an aggressive surgical margin. Incomplete removal of cancer tissue during radical prostatectomy is often associated with poor patient outcomes, including increased likelihood of recurrence and prostate cancer-related mortality.
Prostate-specific membrane antigen (PSMA) ligand positron emission tomography (PET) has emerged as an accurate tool for detecting prostate cancer both in primary staging and during biochemical recurrence. Because PET contrast media also emit photons through a phenomenon called selenium luminescence, researchers sought to evaluate the feasibility and diagnostic accuracy of the CLI in detecting prostate cancer.
Dr. Christopher Dah, resident of the Department of Urology, University of Essen Medical Center, said: Essen, Germany. “The intraoperative use of the CLI enables an examination of the entire prostate surface and provides the surgeon with real-time feedback on the resection margin.”
A single-center study included 10 patients with high-risk primary prostate cancer. After performing a 68Ga-PSMA PET scan, a radical radical prostatectomy and an intraoperative CLI of the resected prostate were performed. CLI images were analyzed postoperatively to determine areas of interest based on signal strength and to calculate tumor to background ratios. CLI tumor margin assessment was performed by analyzing the elevated signal on the surface of an intact prostate image. To determine the accuracy, the tumor marginal condition detected by the CLI was compared to postoperative histopathology.
Tumor cells were successfully detected on an incised prostate CLI image and confirmed by histopathology. Three patients had a positive surgical margin, and in two patients, elevated signal levels allowed correct identification on the CLI. Overall, 25 of the 35 CLI areas of interest have been shown to visualize tumor signaling according to standard histopathology.
Boris A, director of the Urology Clinic at the University of Essen Medical Center. Dr. Hadaschik said: It specifically detects prostate cancer cells. In the future, targeted resection of lymph node metastases may also be performed this way. This new imaging combines urologists and nuclear medicine professionals in the topical treatment of prostate cancer patients. “
Authors of Intraoperative 68 Gallium-PSMA Serenkov Luminescent Imaging for Surgical Margins in Radical Prostatectomy-Feasibility Study: Christopher Dar, Nina N. Hark, Jan Philippe Ratke, Roubaix -Includes Irga, Claudia Kesh, Boris A. Hadashik, and Urology. , University Hospital Essen, Essen, Germany; Maarten R. Grootendorst, Clinical Research, Lightpoint Medical Ltd., Chesham, United Kingdom. Wolfgang P. Fendler, Peter Fragoso Costa, Christopher Rischpler, Christine Praus, Ken Herrmann, Ina Binse; Department of Nuclear Medicine, University Hospital Essen, Essen, Germany. Johannes Haubold, Institute of Diagnostics and Radiology, University Hospital Essen, Essen, Germany. Henning Wraith and Thomas Hugger, Institute of Pathology, University of Duisburg-Essen, Essen, Germany.
The survey was made available online in February 2020, prior to its final publication in print in October 2020.
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