Prostate-specific membrane antigen Radioguided Surgery to Detect Nodal Metastases in Primary Prostate Cancer Patients Undergoing Robot-assisted Radical Prostatectomy and Extended Pelvic Lymph Node Dissection: Results of a Planned Interim Analysis of a Prospective Phase 2 Study

Gandaglia, Giorgio; Mazzone, Elio; Stabile, Armando; Pellegrino, Antony; Cucchiara, Vito; Barletta, Francesco; Scuderi, Simone; Robesti, Daniele; Leni, Riccardo; Gajate, Ana Maria Samanes; Picchio, Maria; Brembilla, Giorgio; Cobelli, Francesco De; Oosterom, Matthias N. van; Leeuwen, F.W.B. van; Montorsi, Francesco; Briganti, Alberto

doi:10.1016/j.eururo.2022.06.002

Cited by 46 publications

(32 citation statements)

References 25 publications

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“…Of these patients, 31 underwent SLNB and 12 (38.7%) had pN1 disease. As the median metastasis size of 2 mm in our cohort lies below the reported 3 mm detection limit of PSMA PET and PSMA-based intraoperative radioguidance techniques [28] , [29] , [30] , it is questionable whether the use of PSMA PET or intraoperative PSMA radioguidance would have impacted the nodal detection rate and treatment allocation given the low sensitivity of PSMA PET for nodal metastases <3 mm [10] , [11] . The diagnostic value of the SLNB procedure in PCa patients with localized disease on PSMA PET/CT will be evaluated in a future study.…”

Section: Discussionmentioning

confidence: 61%

Sentinel Node Procedure to Select Clinically Localized Prostate Cancer Patients with Occult Nodal Metastases for Whole Pelvis Radiotherapy

Barros¹,

Duin²,

Mulder³

et al. 2023

European Urology Open Science

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Section: Discussionmentioning

confidence: 61%

Sentinel Node Procedure to Select Clinically Localized Prostate Cancer Patients with Occult Nodal Metastases for Whole Pelvis Radiotherapy

Barros¹,

Duin²,

Mulder³

et al. 2023

European Urology Open Science

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“…A recent meta-analysis demonstrates that the sensitivity of nodal staging does not exceed 60% [ 55 ]. PSMA radio-guided surgery is also being investigated and has demonstrated some success in intra-operative identification of LNM that are too small for the spatial resolution of PSMA PET-CT or MRI [ 56 ]. The EAU currently recommends the use of novel nomogram developed by Gandaglia et al [ 57 ], which includes mpMRI targeted biopsy results as one of its parameters, along with PSA, clinical stage and maximum diameter of index lesion on mpMRI.…”

Section: Eplnd In the Era Of Psma Pet-ctmentioning

confidence: 99%

PSMA PET-CT in the Diagnosis and Staging of Prostate Cancer

et al. 2022

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Prostate cancer is the most common cancer and the second leading cause of cancer death in men. The imaging assessment and treatment of prostate cancer has vastly improved over the past decade. The introduction of PSMA PET-CT has improved the detection of loco-regional and metastatic disease. PSMA PET-CT also has a role in the primary diagnosis and staging, in detecting biochemical recurrence after curative treatment and in metastasis-directed therapy. In this paper we review the role of PSMA PET-CT in prostate cancer.

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“…According to dosimetry calculations based on the half-life of technetium-99m, the activity in tumour lesions remains in a detectable range for commercially available γ-probes for up to 48 h [ 6 ]. In the current literature, the tracer application was constantly performed between 16 and 24 h before surgical treatment [ 3 , 4 , 5 , 7 , 8 ]. [ 99m Tc]Tc-PSMA-I&S has been tested in robot-assisted radio-guided surgery using a drop-in gamma probe [ 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the current literature, the tracer application was constantly performed between 16 and 24 h before surgical treatment [ 3 , 4 , 5 , 7 , 8 ]. [ 99m Tc]Tc-PSMA-I&S has been tested in robot-assisted radio-guided surgery using a drop-in gamma probe [ 7 , 8 , 9 ]. Currently, the benefits of this procedure are being evaluated in a clinical trial.…”

Section: Introductionmentioning

confidence: 99%

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Development of in-House Synthesis and Quality Control of [99mTc]Tc-PSMA-I&S

Plhak

Pichler²,

Gößnitzer³

et al. 2023

Molecules

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Many radioactive PSMA inhibitory substances have already been developed for PET diagnostics and therapy of prostate cancer. Because PET radionuclides and instrumentation may not be available, technetium-99 m labelled tracers can be considered as a diagnostic alternative. A suitable tracer is [99mTc]Tc-PSMA-I&S, primarily developed for radio-guided surgery, which has been identified for diagnostics of prostate cancer. However, there is no commercial kit approved for the preparation of [99mTc]Tc-PSMA-I&S on the market. This work presents an automated process for the synthesis of [99mTc]Tc-PSMA-I&S concerning good manufacturing practice (GMP). We used a Scintomics GRP 4 V module, with the SCC software package for programming sequences for this development. The optimum reaction conditions were evaluated in preliminary experiments. The pH of the reaction solution was found to be crucial for the radiochemical yield and radiochemical purity. The validation of [99mTc]Tc-PSMA-I&S (n = 3) achieved a stable radiochemical yield of 58.7 ± 1.5% and stable radiochemical purities of 93.0 ± 0.3%. The amount of free [99mTc]TcO4− in the solution and reduced hydrolysed [99mTc]TcO2 was <2%. Our automated preparation of [99mTc]Tc-PSMA-I&S has shown reliability and applicability in the clinical setting.

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Prostate-specific membrane antigen Radioguided Surgery to Detect Nodal Metastases in Primary Prostate Cancer Patients Undergoing Robot-assisted Radical Prostatectomy and Extended Pelvic Lymph Node Dissection: Results of a Planned Interim Analysis of a Prospective Phase 2 Study

Cited by 46 publications

References 25 publications

Sentinel Node Procedure to Select Clinically Localized Prostate Cancer Patients with Occult Nodal Metastases for Whole Pelvis Radiotherapy

Sentinel Node Procedure to Select Clinically Localized Prostate Cancer Patients with Occult Nodal Metastases for Whole Pelvis Radiotherapy

PSMA PET-CT in the Diagnosis and Staging of Prostate Cancer

Development of in-House Synthesis and Quality Control of [99mTc]Tc-PSMA-I&S

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