Novel PET imaging technique detects prostate cancer cells during surgery
A new molecular imaging technique can help surgeons spot cancerous cells during prostate cancer surgery, according to a first-in-person study published recently.
Researchers from University Medical Center Essen in Germany tested Cerenkov luminescence imaging (CLI) in 10 patients with high-risk prostate cancer. They successfully detected residual tumor cells using prostate CLI, confirming their findings with histopathology results.
Christopher Darr, PhD, a resident in the Department of Urology at Essen, noted that while radical prostatectomy is a primary treatment option for men with prostate cancer, in some situations, cancerous cells are missed. This novel intraoperative technique proved capable of limiting these cases, which increase patients’ chance of recurrence.
“Intraoperative radioguidance with CLI may help surgeons in the detection of extracapsular extension, positive surgical margins and lymph node metastases with the aim of increasing surgical precision,” Darr added in a statement on Friday. “The intraoperative use of CLI would allow the examination of the entire prostate surface and provide the surgeon with real-time feedback on the resection margins.”
Cerenkov luminescence is a phenomenon that occurs as molecular imaging agents emit optical photons captured during PET scanning. And given that prostate-specific membrane antigen (PSMA) ligand-PET has grown to be a trusted tool in staging and diagnosing prostate cancer, the researchers set out to determine if CLI could do the same.
Participants in the study first underwent a 68Ga-PSMA-PET scan with subsequent radical prostatectomy. CL imaging was then performed on the surgically removed prostate, with readers determining regions of interest based on signal intensity and tumor-to-background ratios.
Overall, 25 of the 35 CLI regions of interest revealed tumor signaling, as confirmed by standard histopathology. The experts accurately detected tumor cells on the prostate images. Three patients had positive surgical margins, the authors noted, with two CLI scans showing elevated signal levels.
“Radical prostatectomy could achieve significantly higher accuracy and oncological safety, especially in patients with high-risk prostate cancer, through the intraoperative use of radioligands that specifically detect prostate cancer cells,” said Boris A. Hadaschik, PhD, director of the Clinic for Urology at University Medical Center Essen. “In the future, a targeted resection of lymph node metastases could also be performed in this way.”
You can read the entire study, published in the October issue of the Journal of Nuclear Medicine here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.