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The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2021 Jun 09

DOI: 10.23736/S1824-4785.21.03348-3


language: English

Implementation of radioguided surgery in prostate cancer

Anne-Claire BERRENS 1, Pim J. van LEEUWEN 1, Tobias MAURER 2, Boris A. HADASCHIK 3, Ulrich KRAFFT 3

1 Department of Urology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; 2 Department of Urology, Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; 3 Department of Urology, West German Cancer Center, University Hospital Essen, Germany


INTRODUCTION: With the development of new imaging technologies and tracers, the applications of radioguided surgery for prostate cancer are growing rapidly. The current paper aims to give an overview of the recent advances of radioguided surgery in the management of prostate cancer.
EVIDENCE ACQUISITION: We performed a literature search to give an overview of the current status of radioguided surgery for prostate cancer. Three modalities of radioguided surgery, the sentinel node procedure, Cerenkov Luminescence / beta-radio-guided surgery and radio-guided salvage surgery in recurrent prostate cancer, were reviewed in detail.
EVIDENCE SYNTHESIS: Radioguided surgery for prostate cancer has shown promising value in the treatment of primary diagnosed prostate cancer and recurrent loco-regional lymph node positive prostate cancer. Advances have been into minimal invasive (robot-assisted) laparoscopic surgery. The sentinel node procedure for prostate cancer has been further developed and is currently performed with high diagnostic sensitivity. Cerenkov luminescence imaging is a feasible and encouraging technique for intraoperative margin assessment in prostate cancer. Radioguided surgery in recurrent prostate cancer has shown to be feasible, yielding high sensitivity and specificity for detecting small local recurrences and metastases.
CONCLUSIONS: With the availability of different new tracers the road has been paved towards clinically feasible radioguided surgery for prostate cancer. Novel technologies now being developed for minimal invasive surgery are speeding up clinical research. Currently, none of the radioguided surgery techniques mentioned have been accepted as standard of care.

KEY WORDS: Prostate cancer; Radioguided surgery; Sentinel node; PSMA; Image-guided surgery; Radionuclide

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