Intraoperative Molecular Positron Emission Tomography Imaging for Intraoperative Assessment of Radical Prostatectomy Specimens

In this prospective two-center feasibility study, we evaluate the diagnostic value of intraoperative ex vivo specimenPET/CT imaging of radical prostatectomy (RP) and lymphadenectomy specimens. Ten patients with high-risk prostate cancer underwent clinical prostate-specific membrane antigen (PSMA) po...

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Detalles Bibliográficos
Autores principales: Darr, Christopher, Costa, Pedro Fragoso, Kahl, Theresa, Moraitis, Alexandros, Engel, Jenna, Al-Nader, Mulham, Reis, Henning, Köllermann, Jens, Kesch, Claudia, Krafft, Ulrich, Maurer, Tobias, Köhler, Daniel, Klutmann, Susanne, Falkenbach, Fabian, Kleesiek, Jens, Fendler, Wolfgang P., Hadaschik, Boris A., Herrmann, Ken
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Brief Correspondence
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10285557/
https://www.ncbi.nlm.nih.gov/pubmed/37361199
http://dx.doi.org/10.1016/j.euros.2023.05.017
Descripción
Sumario:In this prospective two-center feasibility study, we evaluate the diagnostic value of intraoperative ex vivo specimenPET/CT imaging of radical prostatectomy (RP) and lymphadenectomy specimens. Ten patients with high-risk prostate cancer underwent clinical prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) preoperatively on the day of surgery. Six patients received (68)Ga-PSMA-11 and four (18)F-PSMA-1007. Radioactivity of the resected specimen was measured again using a novel specimenPET/CT device (AURA10; XEOS Medical, Gent, Belgium) developed for intraoperative margin assessment. All index lesions of staging multiparametric magnetic resonance imaging could be visualized. Overall, specimenPET/CT correlated well with conventional PET/CT regarding detection of suspicious tracer foci (Pearson coefficient 0.935). In addition, specimenPET/CT demonstrated all lymph node metastases detected on conventional PET/CT (n = 3), as well as three previously undetected lymph node metastases. Importantly, all positive or close (<1 mm) surgical margins could be visualized in agreement with histopathology. In conclusion, specimenPET/CT enables detection of PSMA-avid lesions and warrants further investigation to tailor RP, based on a good correlation with final pathology. Future trials will prospectively compare ex vivo specimenPET/CT with a frozen section analysis for the detection of positive surgical margins and assessment of biochemical recurrence–free survival. PATIENT SUMMARY: In this report, we examined prostatectomy and lymphadenectomy specimens for suspicious positron emission tomography (PET) signals after preoperative tracer injection. It was found that in all cases, a good signal could be visualized, with a promising correlation of surface assessment compared with histopathology. We conclude that specimenPET imaging is feasible and may help improve oncological outcomes in the future.

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