Paolo Dell'Oglio1, Philippa Meershoek2, Tobias Maurer3, Esther M K Wit4, Pim J van Leeuwen4, Henk G van der Poel4, Fijs W B van Leeuwen5, Matthias N van Oosterom6. 1. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; ORSI Academy, Melle, Belgium; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. 2. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 3. Martini-Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 4. Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 5. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; ORSI Academy, Melle, Belgium; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 6. Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: m.n.van_oosterom@lumc.nl.
Abstract
BACKGROUND: The DROP-IN gamma probe was introduced to overcome the restricted manoeuvrability of traditional laparoscopic gamma probes. Through enhanced manoeuvrability and surgical autonomy, the DROP-IN promotes the implementation of radioguided surgery in the robotic setting. OBJECTIVE: To confirm the utility and safety profile of the DROP-IN gamma probe and to perform a comparison with the traditional laparoscopic gamma probe and fluorescence guidance. DESIGN, SETTING, AND PARTICIPANTS: Twenty-five prostate cancer patients were scheduled for a robot-assisted sentinel lymph node (SN) procedure, extended pelvic lymph node dissection, and prostatectomy at a single European centre. SURGICAL PROCEDURE: After intraprostatic injection of indocyanine green (ICG)-99mTc-nanocolloid (n = 12) or 99mTc-nanocolloid + ICG (n = 13), SN locations were defined using preoperative imaging. Surgical excision of SNs was performed under image guidance using the DROP-IN gamma probe, the traditional laparoscopic gamma probe, and fluorescence imaging. MEASUREMENTS: Intraoperative SN detection was assessed for the different modalities and related to anatomical locations. Patient follow-up was included (a median of 18 mo). RESULTS AND LIMITATIONS: Overall, 47 SNs were pursued in vivo by the DROP-IN gamma probe, of which 100% were identified. No adverse events related to its use were observed. In vivo fluorescence imaging identified 91% of these SNs. The laparoscopic gamma probe identified only 76% of these SNs, where the detection inaccuracies appeared to be related to specific anatomical regions. CONCLUSIONS: Owing to improved manoeuvrability, the DROP-IN probe yielded improved SN detection rates compared with the traditional gamma probe and fluorescence imaging. These findings underline that the DROP-IN technology provides a valuable tool for radioguided surgery in the robotic setting. PATIENT SUMMARY: Radioguided robot-assisted surgery with the novel DROP-IN gamma probe is feasible and safe. It enables more efficient intraoperative identification of sentinel lymph nodes than can be achieved with a traditional laparoscopic gamma probe. The use of the DROP-IN probe in combination with fluorescence imaging allows for a complementary optical confirmation of node localisations.
BACKGROUND: The DROP-IN gamma probe was introduced to overcome the restricted manoeuvrability of traditional laparoscopic gamma probes. Through enhanced manoeuvrability and surgical autonomy, the DROP-IN promotes the implementation of radioguided surgery in the robotic setting. OBJECTIVE: To confirm the utility and safety profile of the DROP-IN gamma probe and to perform a comparison with the traditional laparoscopic gamma probe and fluorescence guidance. DESIGN, SETTING, AND PARTICIPANTS: Twenty-five prostate cancerpatients were scheduled for a robot-assisted sentinel lymph node (SN) procedure, extended pelvic lymph node dissection, and prostatectomy at a single European centre. SURGICAL PROCEDURE: After intraprostatic injection of indocyanine green (ICG)-99mTc-nanocolloid (n = 12) or 99mTc-nanocolloid + ICG (n = 13), SN locations were defined using preoperative imaging. Surgical excision of SNs was performed under image guidance using the DROP-IN gamma probe, the traditional laparoscopic gamma probe, and fluorescence imaging. MEASUREMENTS: Intraoperative SN detection was assessed for the different modalities and related to anatomical locations. Patient follow-up was included (a median of 18 mo). RESULTS AND LIMITATIONS: Overall, 47 SNs were pursued in vivo by the DROP-IN gamma probe, of which 100% were identified. No adverse events related to its use were observed. In vivo fluorescence imaging identified 91% of these SNs. The laparoscopic gamma probe identified only 76% of these SNs, where the detection inaccuracies appeared to be related to specific anatomical regions. CONCLUSIONS: Owing to improved manoeuvrability, the DROP-IN probe yielded improved SN detection rates compared with the traditional gamma probe and fluorescence imaging. These findings underline that the DROP-IN technology provides a valuable tool for radioguided surgery in the robotic setting. PATIENT SUMMARY: Radioguided robot-assisted surgery with the novel DROP-IN gamma probe is feasible and safe. It enables more efficient intraoperative identification of sentinel lymph nodes than can be achieved with a traditional laparoscopic gamma probe. The use of the DROP-IN probe in combination with fluorescence imaging allows for a complementary optical confirmation of node localisations.
Authors: Ilse G T Baeten; Jacob P Hoogendam; Arthur J A T Braat; Ronald P Zweemer; Cornelis G Gerestein Journal: EJNMMI Res Date: 2022-06-20 Impact factor: 3.434
Authors: Elio Mazzone; Paolo Dell'Oglio; Nikos Grivas; Esther Wit; Maarten Donswijk; Alberto Briganti; Fijs Van Leeuwen; Henk van der Poel Journal: J Nucl Med Date: 2021-02-05 Impact factor: 10.057
Authors: Samaneh Azargoshasb; Krijn H M Houwing; Paul R Roos; Sven I van Leeuwen; Michael Boonekamp; Elio Mazzone; Kevin Bauwens; Paolo Dell'Oglio; Fijs W B van Leeuwen; Matthias N van Oosterom Journal: J Nucl Med Date: 2021-01-08 Impact factor: 10.057
Authors: Paolo Dell'Oglio; Danny M van Willigen; Matthias N van Oosterom; Kevin Bauwens; Fabian Hensbergen; Mick M Welling; Huijbert van der Stadt; Elise Bekers; Martin Pool; Pim van Leeuwen; Tobias Maurer; Fijs W B van Leeuwen; Tessa Buckle Journal: EJNMMI Res Date: 2022-03-07 Impact factor: 3.138
Authors: Imke Boekestijn; Matthias N van Oosterom; Paolo Dell'Oglio; Floris H P van Velden; Martin Pool; Tobias Maurer; Daphne D D Rietbergen; Tessa Buckle; Fijs W B van Leeuwen Journal: Cancer Imaging Date: 2022-09-06 Impact factor: 5.605
Authors: Thomas Wendler; Fijs W B van Leeuwen; Nassir Navab; Matthias N van Oosterom Journal: Eur J Nucl Med Mol Imaging Date: 2021-06-29 Impact factor: 9.236