Robotgeassisteerde PSMA-radiogeleide chirurgie bij recidiverend prostaatkanker met de DROP-IN-gammaprobe: Het eerste prospectieve haalbaarheidsonderzoek

This prospective, in vivo feasibility study with 20 patients with recurrent prostate cancer (PCa) evaluated whether a miniaturized DROP-IN gamma probe enables robot-assisted prostate-specific membrane antigen (PSMA)-targeted radioguided surgery (RGS; NCT03857113). We included patients with up to three pelvic PCa recurrences (nodal or local) on PSMA positron emission tomography (PET) after previous curative-intent therapy. Robot-assisted PSMA-RGS using the DROP-IN gamma probe was carried out after intravenous injection of a 99mTechnetium-labelled PSMA-ligand (99mTc-PSMA-I&S). The primary endpoint was the feasibility of robot-assisted PSMA-RGS. Using the DROP-IN probe, we were able to robotically resect 19 out of 21 (90%) preoperatively identified lesions. The per-lesion ex vivo sensitivity and specificity of robot-assisted PSMA-RGS was 86% and 100%, respectively. One patient suffered from a Clavien-Dindo grade V complication. We therefore conclude that the DROP-IN probe helps to realize robot-assisted PSMA-RGS. This procedure is technically feasible for the intraoperative detection of both nodal and local PCa recurrences.