Back-Table Imaging in Prostate Cancer Surgery Enhances Diagnostic Accuracy

Strategic Insights -

Researchers at Leiden University Medical Center have published a study on the use of back-table imaging in prostate cancer surgery, specifically in relation to prostate-specific membrane antigen (PSMA) targeted precision surgery. The study aimed to investigate the feasibility and performance of handheld single-photon emission computed tomography (hSPECT) combined with light detection and ranging (LiDAR) in analyzing tissue specimens excised after robotic Tc-PSMA-radioguided surgery.

Key Takeaways:

  • The study included 5 prostate cancer patients undergoing primary or salvage robot-assisted resection of Tc-PSMA-I&S avid lesions.
  • 12 tissue samples (1 prostatic tissue, 1 local recurrence tissue, 10 lymph nodes) were analyzed ex vivo using a custom-built specimen tray and hSPECT/LiDAR imaging.
  • hSPECT/LiDAR imaging provided accurate representation of Tc-PSMA-I&S uptake within the specimens in all 12 samples.
  • In 8 samples, it helped confirm a true positive lesion, and in the remaining 4 samples, non-visualization aligned with negative histopathology (true negative).
  • A strong correlation was found between hSPECT/LiDAR and PSMA-PET/CT (p < 0.05).
  • The study concluded that hSPECT/LiDAR is a technically feasible 3D hybrid modality for back-table assessment of surgical specimens from the robotic Tc-PSMA-radioguided surgery workflow.

Statistics:

  • 5 prostate cancer patients were included in the study.
  • 12 tissue samples were analyzed ex vivo using hSPECT/LiDAR imaging.
  • hSPECT/LiDAR imaging provided accurate representation of Tc-PSMA-I&S uptake in 100% of the samples.
  • Spearman's correlation coefficient was 0.85, indicating a strong positive correlation between hSPECT/LiDAR and PSMA-PET/CT.

Sources:

  • Back-table specimen scanning using gantry-free hybrid hSPECT/LiDAR imaging: a feasibility study during PSMA-radioguided surgery. Surgical Endoscopy, 2025.
  • NewsRx. Studies from Leiden University Medical Center Have Provided New Data on Robotics (Back-table specimen scanning using gantry-free hybrid hSPECT/LiDAR imaging: a feasibility study during PSMA-radioguided surgery). Medical Devices & Surgical Technology Week. September 21, 2025; p 3371.