MP82-11 IMPACT OF TUMOR VOLUME PERCENTAGE TO PROSTATE VOLUME ON THE RISK OF BIOCHEMICAL RECURRENCE AFTER RADICAL PROSTATECTOMY

Autor: Ohseong Kwon, Sung Kyu Hong, Young Ik Lee, In Jae Lee, Seong Jin Jeong, Seok-Soo Byun, Sangchul Lee, Jeong Hyun Kim, Jong Jin Oh, Choong Hee Noh, Ki Bom Kim, Sang Eun Lee, Hakmin Lee, Jung Ki Jo
Rok vydání: 2015
Předmět:
Zdroj: Journal of Urology. 193
ISSN: 1527-3792
0022-5347
DOI: 10.1016/j.juro.2015.02.530
Popis: visualized. However, these lesions might not be easy to localize intraoperatively. Thus, the aim of this feasibility study was to evaluate intraoperative detection of metastatic lesions using a gamma probe after injection of a radiolabelled PSMA-ligand in correlation with postoperative histological findings. METHODS: 9 consecutive PCa patients with rising PSA after curative treatment (Median: 1.3ng/ml, range: 0.2 e 4.7ng/ml) and evidence of recurrent disease within the pelvis on 68Ga-HBEDPSMA PET hybrid imaging were included in this analysis. 24 hours before surgery patients received an intravenous injection of 111Inlabelled PSMA-I&T. Intraoperatively, metastatic lesions were detected by gamma probe with acoustic and visual feedback. Using the freehand SPECT technique optical tracking of the gamma probe allowed augmenting the live video stream of the field of surgery with reconstructed 3D image showing the position of positive lesions. Results of ex vivo radioactive rating (positive vs. negative) of resected tissue were compared to findings of postoperative histological analysis. RESULTS: In total, 32 separate histological specimens were evaluated (Median: 2, range: 2 e 7) and 15 specimens contained metastatic lesions at histological analysis. Lesions declared radioactive-positive intraoperatively and exhibiting a positive signal by the gamma probe ex vivo corresponded to metastatic PCa lesions with a sensitivity of 93.3% and a specificity of 100%. Detection of lesions as well as complete resection of even small metastatic lymph nodes was facilitated by the use of the gamma probe. Compared to preoperative 68Ga-HBED-PSMA PET hybrid imaging the intraoperative use of the gamma probe might even be more accurate as it detected all positive lesions and even additional lesions as small as 2mm. CONCLUSIONS: In this initial series, PSMA-radioguided surgery proved to be of high value for intraoperative detection of even small metastatic lesions in PCa patients. However, adequate patient selection for this individual treatment concept is crucial. Furthermore, greater patient numbers including follow-up data are needed to determine its possible role in clinical routine.
Databáze: OpenAIRE
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