Real-Time Identification of Nodal Metastases With Tc-99m-Prostate-Specific Membrane Antigen-Based Radioguidance and Indocyanine Green Fluorescence Imaging in Primary Prostate Cancer Surgery-On the Road to Hybrid Image-Guided Surgery

Recent developments in image-guided prostate cancer surgery focus on extending prostate-specific membrane antigen-directed radioguidance with optical tumor detection using fluorescence, as radio- and fluorescence signals complement each other with in-depth detection and real-time visualization, respectively. As a step in this direction, we report here the integration of indocyanine green fluorescence imaging into a Tc-99m-prostate-specific membrane antigen-targeted radioguided surgery workflow.

Automated summary

Recent advances in image-guided prostate cancer surgery involve integrating fluorescence imaging with radioguided surgery, using prostate-specific membrane antigen targeting. This combination of radio- and fluorescence signals enhances detection accuracy and provides real-time visualization. In this study, we successfully integrated indocyanine green fluorescence imaging into a Tc-99m-prostate-specific membrane antigen-targeted radioguided surgery workflow.