A tethered laparoscopic gamma probe for radioguided surgery in prostate cancer – usability and technical feasibility evaluation in a pelvic phantom and porcine model

2019 ◽  
Vol 18 (1) ◽  
pp. e1769
Author(s):  
J. Adshead ◽  
F. Oldfield ◽  
B. Hadaschik ◽  
W. Everaerts ◽  
A. Mestre-Fusco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Porcine Model ◽  
Gamma Probe ◽  
Radioguided Surgery ◽  
Technical Feasibility ◽  
Feasibility Evaluation

scholarly journals MP20-04 USABILITY AND TECHNICAL FEASIBILITY EVALUATION OF A TETHERED LAPAROSCOPIC GAMMA PROBE FOR RADIOGUIDED SURGERY IN PROSTATE CANCER: A PELVIC PHANTOM AND PORCINE MODEL STUDY

2019 ◽  
Vol 201 (Supplement 4) ◽  
Author(s):  
Jim Adshead ◽  
Francesca Oldfield ◽  
Boris Hadaschik ◽  
Jim Adshead Wouter Everaerts ◽  
Antoni Mestre-Fusco ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Porcine Model ◽  
Gamma Probe ◽  
Radioguided Surgery ◽  
Technical Feasibility ◽  
Model Study ◽  
Feasibility Evaluation

scholarly journals Robotic surgery using a DROP-IN beta probe – feasibility study with 68Ga-PSMA in prostate cancer specimens

2020 ◽  
Author(s):  
Francesco Collamati ◽  
Matthias van Oosterom ◽  
Micol De Simoni ◽  
Riccardo Faccini ◽  
Marta Fischetti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Ex Vivo ◽  
Gamma Probe ◽  
Beta Particle ◽  
Radioguided Surgery ◽  
Robot Assisted ◽  
Tumor Identification ◽  
Psma Pet ◽  
Positive Lymph Nodes

Abstract Background: Recently, a flexible DROP-IN gamma-probe was introduced for robot-assisted radioguided surgery, using traditional low-energy SPECT-isotopes. This study explores the use of a novel DROP-IN beta-particle (DROP-IN b ) detection probe to support the implementation of the large number of PET-tracers available during robot-assisted tumor-receptor-targeted resections. Methods: Following engineering of the DROP-IN b probe, robotic implementation was investigated using surgical specimens. Seven prostate cancer patients with PSMA-PET positive tumors received an intraoperative injection of ~100 MBq 68 Ga-PSMA-11, followed by prostatectomy and extended pelvic lymph node dissection. Results: The probe was able to identify the position of the tumor in the prostate specimens: S/B was > 5 when pathology confirmed that the tumor was located <1 mm below the specimen surface. PSMA-PET positive lymph nodes, as found in two patients, could be identified with the DROP-IN b probe (S/B>3). Conclusions: This ex vivo study underlines the potential to use a DROP-IN b probe for intraoperative tumor identification on the prostate surface and confirmation of PSMA-PET positive lymph nodes.

scholarly journals A DROP-IN Beta Probe for Robot-Assisted 68Ga-PSMA Radioguided Surgery: First Ex Vivo Technology Evaluation Using Prostate Cancer Specimens

2020 ◽  
Author(s):  
Francesco Collamati ◽  
Matthias van OOsterom ◽  
Micol De Simoni ◽  
Riccardo Faccini ◽  
Marta Fischetti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Ex Vivo ◽  
Gamma Probe ◽  
Beta Particle ◽  
Radioguided Surgery ◽  
Robot Assisted ◽  
Psma Pet ◽  
Positive Lymph Nodes

Abstract Background: Recently, a flexible DROP-IN gamma-probe was introduced for robot-assisted radioguided surgery, using traditional low-energy SPECT-isotopes. In parallel, a novel approach to achieve sensitive radioguidance using beta-emitting PET-isotopes has been proposed. Integration of these two concepts would allow to exploit the use of PET-tracers during robot-assisted tumor-receptor-targeted. In this study, we’ve engineered and validated the performance of a novel DROP-IN beta-particle (DROP-INb) detector.Methods: Seven prostate cancer patients with PSMA-PET positive tumors received an additional intraoperative injection of ~70 MBq 68Ga-PSMA-11, followed by robot-assisted prostatectomy and extended pelvic lymph node dissection. The surgical specimens from these procedures were used to validate the performance of our DROP-INb probe prototype, with merged a scintillating detector with a housing optimized for a 12 mm trocar and prograsp instruments. Results: After optimization of the detector and probe housing via Monte Carlo simulations, the resulting DROP-INb probe prototype was tested in a robotic setting. In the ex vivo setting, the probe – positioned by the robot- was able to identify 68Ga-PSMA-11 containing hot-spots in the surgical specimens: signal-to-background (S/B) was > 5 when pathology confirmed that the tumor was located <1 mm below the specimen surface. 68Ga-PSMA-11 containing (and PET positive) lymph nodes, as found in two patients, were also confirmed with the DROP-INb probe (S/B>3). The rotational freedom of the DROP-IN design and the ability to manipulate the probe with the prograsp tool allowed the surgeon to perform autonomous beta tracing. Conclusions: This study demonstrates the feasibility of beta-radioguided surgery in a robotic context by means of a DROP-INb detector. When translated to an in vivo setting in the future, this technique could provide a valuable tool in detecting tumor remnants on the prostate surface and in confirmation of PSMA-PET positive lymph nodes.

scholarly journals A DROP-IN beta probe for robot-assisted 68Ga-PSMA radioguided surgery: first ex vivo technology evaluation using prostate cancer specimens

2020 ◽  
Author(s):  
Francesco Collamati ◽  
Matthias van OOsterom ◽  
Micol De Simoni ◽  
Riccardo Faccini ◽  
Marta Fischetti ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Ex Vivo ◽  
Gamma Probe ◽  
Beta Particle ◽  
Radioguided Surgery ◽  
Robot Assisted ◽  
Psma Pet ◽  
Positive Lymph Nodes

Abstract Background: Recently, a flexible DROP-IN gamma-probe was introduced for robot-assisted radioguided surgery, using traditional low-energy SPECT-isotopes. In parallel, a novel approach to achieve sensitive radioguidance using beta-emitting PET-isotopes has been proposed. Integration of these two concepts would allow to exploit the use of PET-tracers during robot-assisted tumor-receptor-targeted. In this study, we’ve engineered and validated the performance of a novel DROP-IN beta-particle (DROP-INb) detector.Methods: Seven prostate cancer patients with PSMA-PET positive tumors received an additional intraoperative injection of ~70 MBq 68Ga-PSMA-11, followed by robot-assisted prostatectomy and extended pelvic lymph node dissection. The surgical specimens from these procedures were used to validate the performance of our DROP-INb probe prototype, which merged a scintillating detector with a housing optimized for a 12 mm trocar and prograsp instruments. Results: After optimization of the detector and probe housing via Monte Carlo simulations, the resulting DROP-INb probe prototype was tested in a robotic setting. In the ex vivo setting, the probe – positioned by the robot- was able to identify 68Ga-PSMA-11 containing hot-spots in the surgical specimens: signal-to-background (S/B) was > 5 when pathology confirmed that the tumor was located <1 mm below the specimen surface. 68Ga-PSMA-11 containing (and PET positive) lymph nodes, as found in two patients, were also confirmed with the DROP-INb probe (S/B>3). The rotational freedom of the DROP-IN design and the ability to manipulate the probe with the prograsp tool allowed the surgeon to perform autonomous beta tracing. Conclusions: This study demonstrates the feasibility of beta-radioguided surgery in a robotic context by means of a DROP-INb detector. When translated to an in vivo setting in the future, this technique could provide a valuable tool in detecting tumor remnants on the prostate surface and in confirmation of PSMA-PET positive lymph nodes.

scholarly journals Computed tomography-guided preoperative localization of musculoskeletal lesions using the ROLL technique

2018 ◽  
Vol 51 (3) ◽  
pp. 147-150 ◽  
Author(s):  
Chiang Jeng Tyng ◽  
Paula Nicole Vieira Pinto Barbosa ◽  
Almir Galvão Vieira Bitencourt ◽  
Maurício Kauark Amoedo ◽  
Maria Fernanda Arruda Almeida ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Gamma Probe ◽  
Preoperative Localization ◽  
Bone Lesions ◽  
Radioguided Surgery ◽  
Previous Diagnosis ◽  
Occult Lesion ◽  
Intraoperative Localization ◽  
Lesion Localization ◽  
Musculoskeletal Lesions

Abstract Objective: To describe the preoperative localization of musculoskeletal lesions with the radioguided occult lesion localization (ROLL) technique. Materials and Methods: In all cases, computed tomography-guided injection of technetium-99m sulfur colloid was performed, directly into or near the suspicious lesion, up to 36 hours before the surgical procedure. Lesions were detected intraoperatively with a gamma probe. Results: We report the cases of six patients submitted to radioguided surgery, including three patients with bone lesions suspicious for metastasis, two patients suspected of recurrent sarcoma, and one patient with no previous diagnosis who had a nodular lesion on the left leg. Patients tolerated the procedure well, and no complications were associated with the puncture. All marked lesions were easily identified intraoperatively and were excised with clear margins. Conclusion: The ROLL technique was effective in the intraoperative localization of occult musculoskeletal lesions, demonstrating that it is a feasible and promising technique for the surgical exploration of selected cases.

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