Multispectral-Fluorescence Imaging as a Tool to Separate Healthy from Disease-Related Lymphatic Anatomy During Robot-Assisted Laparoscopy

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
Philippa MeershoekFijs W B van Leeuwen

Abstract

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. Methods: 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. Results: 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. Conclusion: We demonstrated that the differences in lymphatic flow pattern between the prostate and lower limbs could be intraoperatively distinguished using multispectral-fluorescence imaging.

References

May 12, 2009·European Journal of Nuclear Medicine and Molecular Imaging·G HollJ Sciuk
Jun 24, 2015·Radiology·Fijs W B van LeeuwenArian R van Erkel
Jul 29, 2015·Acta Obstetricia Et Gynecologica Scandinavica·Barbara Geppert, Jan Persson
Sep 19, 2016·European Urology·Esther M K WitHenk G van der Poel
Feb 17, 2018·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Tessa BuckleFijs W B van Leeuwen

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Citations

Nov 13, 2020·Journal of Robotic Surgery·Philippa MeershoekMatthias N van Oosterom
Jan 27, 2021·The Quarterly Journal of Nuclear Medicine and Molecular Imaging : Official Publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutica·Daphne D RietbergenTessa Buckle
Nov 17, 2019·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Tobias MaurerFijs W B van Leeuwen
Jun 30, 2021·European Journal of Nuclear Medicine and Molecular Imaging·Thomas WendlerMatthias N van Oosterom
Dec 20, 2019·Bioconjugate Chemistry·Albertus Wijnand HensbergenFijs W B van Leeuwen
Jun 1, 2021·The Quarterly Journal of Nuclear Medicine and Molecular Imaging : Official Publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of Radiopharmaceutica·Hielke Martijn DE VriesTessa Buckle

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