Multispectral Fluorescence Imaging as a Tool to Distinguish Pelvic Lymphatic Drainage Patterns During Robot-assisted Lymph Node Dissection in Prostate Cancer
2024

Using Multispectral Imaging to Map Lymphatic Drainage in Prostate Cancer Surgery

Sample size: 16 publication 10 minutes Evidence: moderate

Author Information

Author(s): Berrens Anne-Claire MD, Buckle Tessa PhD, van Oosterom Matthias N. PhD, Slof Leon J., van Leeuwen Pim J. MD, PhD, Wit Esther M. K. MD, de Barros Hilda A. MD, Nieuwenhuijzen Jakko A. MD, PhD, Bekers Elise M. MD, Donswijk Maarten L. MD, van Leeuwen Fijs W. B. PhD, van der Poel Henk G. MD, PhD

Primary Institution: Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands

Hypothesis

Can multispectral fluorescence imaging effectively distinguish lymphatic drainage patterns during robot-assisted lymph node dissection in prostate cancer patients?

Conclusion

Multispectral imaging can distinguish lymphatic drainage patterns, but fluorescein is unsuitable for confirming fluorescence at histopathology.

Supporting Evidence

  • Fluorescein was visible in lymph vessels but not in tumor-positive nodes.
  • Indocyanine green and fluorescein co-accumulated in lymph vessels in vivo.
  • Administration of fluorescein did not result in discomfort or abnormal recovery.

Takeaway

Doctors used special cameras to see how lymph flows during prostate cancer surgery, helping them avoid unnecessary cuts.

Methodology

A prospective study involving 16 patients undergoing robot-assisted radical prostatectomy with multispectral fluorescence imaging.

Potential Biases

Potential bias due to varying surgeon experience and patient selection.

Limitations

Small sample size and single-center study may limit generalizability.

Participant Demographics

16 male patients, median age 66.5 years, with a calculated risk of lymph node invasion >5%.

Statistical Information

P-Value

<0.05

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1245/s10434-024-16423-1

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