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.
J Nucl Med. 2018 Nov;59(11):1757-1760. doi: 10.2967/jnumed.118.211888. Epub 2018 May 18.
To reduce the invasive nature of extended pelvic lymph node (LN) dissections in prostate cancer, we have developed a multispectral-fluorescence guidance approach that enables discrimination between prostate-draining LNs and lower-limb-draining LNs. In 5 pigs, multispectral-fluorescence guidance was used on da Vinci Si and da Vinci Xi robots. The animals received fluorescein into the lower limb and indocyanine green-nanocolloid into the prostate. Fluorescein was detected in 29 LNs (average of 3.6 LNs/template), and indocyanine green-nanocolloid was detected in 12 LNs (average of 1.2 LNs/template). Signal intensities appeared equal for both dyes, and no visual overlap in lymphatic drainage patterns was observed. Furthermore, fluorescein supported both the identification of leakage from damaged lymphatic structures and the identification of ureters. We demonstrated that the differences in lymphatic flow pattern between the prostate and lower limbs could be intraoperatively distinguished using multispectral-fluorescence imaging.
为了降低前列腺癌广泛盆腔淋巴结清扫术的侵袭性，我们开发了一种多光谱荧光引导方法，能够区分前列腺引流淋巴结和下肢引流淋巴结。在 5 头猪中，在达芬奇 Si 和达芬奇 Xi 机器人上使用了多光谱荧光引导。动物将荧光素注入下肢，将吲哚菁绿纳米胶乳注入前列腺。在 29 个淋巴结中检测到荧光素（平均每个模板 3.6 个淋巴结），在 12 个淋巴结中检测到吲哚菁绿纳米胶乳（平均每个模板 1.2 个淋巴结）。两种染料的信号强度似乎相等，没有观察到淋巴引流模式的视觉重叠。此外，荧光素不仅支持识别受损淋巴结构的渗漏，还支持识别输尿管。我们证明，使用多光谱荧光成像可以在术中区分前列腺和下肢之间的淋巴血流模式差异。
