A Systematic Review of New Imaging Technologies for Robotic Prostatectomy: From Molecular Imaging to Augmented Reality

Abstract

New imaging technologies play a pivotal role in the current management of patients with prostate cancer. Robotic assisted radical prostatectomy (RARP) is a standard of care for localized disease and through the already imaging-based console subject of research towards combinations of imaging technologies and RARP as well as their impact on surgical outcomes. Therefore, we aimed to provide a comprehensive analysis of the currently available literature for new imaging technologies for RARP. On 24 January 2023, we performed a systematic review of the current literature on Pubmed, Scopus and Web of Science according to the PRISMA guidelines and Oxford levels of evidence. A total of 46 studies were identified of which 19 studies focus on imaging of the primary tumor, 12 studies on the intraoperative tumor detection of lymph nodes and 15 studies on the training of surgeons. While the feasibility of combined approaches using new imaging technologies including MRI, PSMA-PET CT or intraoperatively applied radioactive and fluorescent dyes has been demonstrated, the prospective confirmation of improvements in surgical outcomes is currently ongoing.

Artificial Intelligence and Augmented Reality: Transforming Urology?

“…Additionally, it can assist in minimizing the risk of complications by indicating the real-time location of fragile structures [20]. Once again, a highly researched field of application has been that of partial nephrectomies, but various uro-oncological and reconstructive procedures have also been evaluated [21].…”

Exploring Augmented Reality Integration in Diagnostic Imaging: Myth or Reality?

“…From the comprehensive examination of the systematic reviews [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56], a resounding narrative emerges, underscoring the pervasive utilization and transformative influence of augmented reality AR and VR technologies across diverse surgical domains, spanning orthopedics, neurosurgery, and oncology. Central to this narrative is the profound enhancement in surgical precision, a recurrent theme echoed in systematic reviews authored by Sun et al [41], Guha et al [43], Dubron et al [44], and Sparwasser et al [49].…”

“…Rodler et al [46] demonstrate the potential of combining various imaging modalities with robotic-assisted surgery, although prospective studies confirming the benefits are still in progress. Their review categorizes studies based on imaging of the primary tumor, the intraoperative detection of lymph nodes, and surgeon training, highlighting the potential of combining imaging modalities such as MRI and PET CT with robotic-assisted procedures.…”

“…AR technology stands at the forefront of surgical innovation, poised to potentially revolutionize the field and elevate patient care standards [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56]. By seamlessly integrating digital information into surgical environments, AR equips surgeons with unparalleled levels of visualization, spatial awareness, and precision.…”

“…Our exploration encompassed an analysis of both the "title/abstract" and the "full text" of relevant studies. At the end of the two selection stages, starting from 59 initial studies, 16 systematic reviews were selected [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] (Figure 1). In addition to the comprehensive search strategy outlined previously, the quest expanded its focus to include the pivotal keyword "COVID-19".…”