Cerenkov Luminescence Imaging in Prostate Cancer: Not the Only Light That Shines.

Autor:	Heuvel JO; Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands.; Technical Medical Centre, University of Twente, Enschede, The Netherlands., de Wit-van der Veen BJ; Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands; l.vd.veen@nki.nl., van der Poel HG; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., van Leeuwen PJ; Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Bekers EM; Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands; and., Grootendorst MR; Lightpoint Medical Ltd., Chesham, United Kingdom., Vyas KN; Lightpoint Medical Ltd., Chesham, United Kingdom., Slump CH; Technical Medical Centre, University of Twente, Enschede, The Netherlands., Stokkel MPM; Department of Nuclear Medicine, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2022 Jan; Vol. 63 (1), pp. 29-35. Date of Electronic Publication: 2021 Apr 30.
DOI:	10.2967/jnumed.120.260034
Abstrakt:	Cerenkov luminescence imaging (CLI) is a novel imaging technology that might have the ability to assess surgical margins intraoperatively during prostatectomy using 68 Ga-prostate-specific membrane antigen ( 68 Ga-PSMA-11). This study evaluated the accuracy of CLI compared with histopathology and, as an exploratory objective, investigated the characteristics of the identified chemiluminescence signal. Methods: After intravenous injection of a mean 68 Ga-PSMA-11 activity of 69 MBq intraoperatively, all excised specimens were imaged with CLI. Areas of increased signal were marked for histopathologic comparison and scored for the likelihood of being a positive surgical margin (PSM) using a 5-point Likert scale. In addition, the chemiluminescence signal was investigated in 3 radioactive and 3 nonradioactive specimens using CLI. Results: In 15 patients, the agreement between CLI and histopathology was 60%; this improved to 83% when including close surgical margins (≤1 mm). In 6 hot spots, CLI correctly identified PSMs on histopathology, located at the apex and mid prostate. In all 15 patients, an increased signal at the prostate base was observed, without the presence of the primary tumor in this area in 8 patients. This chemiluminescence signal was also observed in nonradioactive prostate specimens, with a half-life of 48 ± 11 min. The chemiluminescence hampered the visual interpretation of 4 PSMs at the base. Conclusion: CLI was able to correctly identify margin status, including close margins, in 83% of the cases. The presence of a diathermy-induced chemiluminescent signal hampered image interpretation, especially at the base of the prostate. In the current form, CLI is most applicable to detect PSMs and close margins in the apex and mid prostate. (© 2022 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze:	MEDLINE
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