Department of Surgery, Royal Melbourne Hospital, Parkville, Melbourne, VIC, Australia.
Young Urology Research Organisation (YURO), Melbourne, Australia.
World J Urol. 2019 Jul;37(7):1251-1254. doi: 10.1007/s00345-018-2282-y. Epub 2018 Apr 3.
Prostate Specific Membrane Antigen Positron Emission Tomography/Computed Tomography (PSMA-PET/CT) has increased the sensitivity and specificity of imaging to identify metastatic prostate cancer in the group of patients with early biochemical recurrence when compared to conventional imaging. In patients who develop biochemical recurrence of prostate cancer following surgical resection, salvage lymph node dissection may reduce prostate specific antigen (PSA) levels and delay the time for commencement of systemic therapies. However, PLND may be an anatomically and technically difficult procedure, particularly with small metastatic diseases which can be problematic for intra-operative identification. We describe the technique using PSMA-PET imaging to pre-operatively localise areas of low-volume nodal metastatic disease with hookwire to allow targeted lymph node dissection with direct visualisation and palpation to ensure adequate clearance of involved nodes.
前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描（PSMA-PET/CT）与传统影像学相比，提高了对早期生化复发患者中转移性前列腺癌的成像的敏感性和特异性。对于接受手术切除后前列腺癌发生生化复发的患者，挽救性淋巴结切除术可能会降低前列腺特异性抗原（PSA）水平并延迟开始全身治疗的时间。然而，PLND 可能是一种解剖和技术上具有挑战性的手术，尤其是对于小的转移性疾病，这在术中识别时可能会出现问题。我们描述了使用 PSMA-PET 成像来对低体积淋巴结转移疾病进行术前定位的技术，以便使用钩线将其定位，从而允许进行靶向淋巴结切除术，并直接可视化和触诊以确保充分清除受累淋巴结。
