Scholarlink

Introduction <p>Prostate-specific membrane antigen (PSMA) targeted precision surgery is becoming increasingly popular. However, the relatively low levels of PSMA-receptor expression and background signal can hinder in vivo lesion detection and margin evaluation. Back-table imaging (ex vivo) potentially provides a means to confirm surgical accuracy. For <sup>99m</sup>Tc-PSMA-radioguided surgery, an innovative gantry-free hybrid imaging technique has recently been proposed, namely handheld single-photon emission computed tomography (<i>h</i>SPECT) combined with light detection and ranging (LiDAR). This study aimed to assess the feasibility and performance of <i>h</i>SPECT/LiDAR in analyzing tissue specimens excised after robotic <sup>99m</sup>Tc-PSMA-radioguided surgery.</p> Methods <p>We included samples from 5 prostate cancer patients undergoing primary or salvage robot-assisted resection of <sup>99m</sup>Tc-PSMA-I&amp;S avid lesions that were identified using a drop-in gamma probe. 12 samples (1 prostatic tissue, 1 local recurrence tissue, 10 lymph nodes) were analyzed ex vivo using a custom-built specimen tray, including an optical reference tracker for scan registration. LiDAR was used to acquire a surface scan of the specimens, and the 3D OBJ image output was fused with the 3D DICOM of a <i>h</i>SPECT obtained using a handheld gamma camera and DeclipseSPECT tracking system.</p> Results <p><i>h</i>SPECT/LiDAR imaging provided accurate representation of the <sup>99m</sup>Tc-PSMA-I&amp;S uptake within the specimens. In 8 samples, it helped to confirm a true positive lesion. In the remaining 4 samples, non-visualization aligned with negative histopathology (true negative). A strong correlation was found between PSMA-<i>h</i>SPECT/LiDAR and PSMA-PET/CT (<i>p</i> &lt; 0.05), but no correlation could be established with PSMA-SPECT/CT (<i>p</i> = 0.515). The count rates fount in the scan correlated to tumor size (<i>p</i> = 0.016) and were not influenced by the overall specimen’s size (<i>p</i> = 0.558).</p> Conclusion <p>We present the technical feasibility of a new 3D hybrid modality (<i>h</i>SPECT/LiDAR) that allows back-table assessment of surgical specimens from the already well validated robotic <sup>99m</sup>Tc-PSMA-radioguided surgery workflow.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Back-table specimen scanning using gantry-free hybrid hSPECT/LiDAR imaging: a feasibility study during PSMA-radioguided surgery

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月25日

查看全文
  • Giusi Pisano,
  • Matthias N. van Oosterom,
  • Vera A. Ottens,
  • Anne-Claire Berrens,
  • Leon J. Slof,
  • Berkay A. Çakal,
  • Daphne D. D. Rietbergen,
  • Henk G. van der Poel,
  • Pim J. van Leeuwen,
  • Fijs W. B. van Leeuwen

摘要

Introduction

Prostate-specific membrane antigen (PSMA) targeted precision surgery is becoming increasingly popular. However, the relatively low levels of PSMA-receptor expression and background signal can hinder in vivo lesion detection and margin evaluation. Back-table imaging (ex vivo) potentially provides a means to confirm surgical accuracy. For 99mTc-PSMA-radioguided surgery, an innovative gantry-free hybrid imaging technique has recently been proposed, namely handheld single-photon emission computed tomography (hSPECT) combined with light detection and ranging (LiDAR). This study aimed to assess the feasibility and performance of hSPECT/LiDAR in analyzing tissue specimens excised after robotic 99mTc-PSMA-radioguided surgery.

Methods

We included samples from 5 prostate cancer patients undergoing primary or salvage robot-assisted resection of 99mTc-PSMA-I&S avid lesions that were identified using a drop-in gamma probe. 12 samples (1 prostatic tissue, 1 local recurrence tissue, 10 lymph nodes) were analyzed ex vivo using a custom-built specimen tray, including an optical reference tracker for scan registration. LiDAR was used to acquire a surface scan of the specimens, and the 3D OBJ image output was fused with the 3D DICOM of a hSPECT obtained using a handheld gamma camera and DeclipseSPECT tracking system.

Results

hSPECT/LiDAR imaging provided accurate representation of the 99mTc-PSMA-I&S uptake within the specimens. In 8 samples, it helped to confirm a true positive lesion. In the remaining 4 samples, non-visualization aligned with negative histopathology (true negative). A strong correlation was found between PSMA-hSPECT/LiDAR and PSMA-PET/CT (p < 0.05), but no correlation could be established with PSMA-SPECT/CT (p = 0.515). The count rates fount in the scan correlated to tumor size (p = 0.016) and were not influenced by the overall specimen’s size (p = 0.558).

Conclusion

We present the technical feasibility of a new 3D hybrid modality (hSPECT/LiDAR) that allows back-table assessment of surgical specimens from the already well validated robotic 99mTc-PSMA-radioguided surgery workflow.