PSMA-PET guided hook-wire localization of nodal metastases in prostate cancer: a targeted approach
Prostate Specific Membrane Antigen Positron Emission Tomography/Computed Tomography (PSMA-PET/CT) has increased the sensitivity and specificity of imaging to identify metastatic prostate cancer in the group of patients with early biochemical recurrence when compared to conventional imaging. In patients who develop biochemical recurrence of prostate cancer following surgical resection, salvage lymph node dissection may reduce prostate specific antigen (PSA) levels and delay the time for commencement of systemic therapies. However, PLND may be an anatomically and technically difficult procedure, particularly with small metastatic diseases which can be problematic for intra-operative identification. We describe the technique using PSMA-PET imaging to pre-operatively localise areas of low-volume nodal metastatic disease with hookwire to allow targeted lymph node dissection with direct visualisation and palpation to ensure adequate clearance of involved nodes.
KeywordsImage guided surgery Hookwire Prostate cancer Pelvic lymph node dissection PET-PSMA scan Lymph node metastasis
Lymph node dissection
Positron emission tomography
Prostate specific antigen
Prostate specific membrane antigen
E Clarebrough: Manuscript writing/editing, D Cristidis: Data collection or management, Manuscript writing/editing, C Duncan: Manuscript writing/editing, A Lavoipierre: Protocol/project development, Data collection or management, N Lawrentschuk: Protocol/project development, Data collection or management
Compliance with ethical standards
Conflict of interest
All of the authors declare that they have no conflict of interest.
The individual re-identifiable data included in this article were included with the informed consent of the patient.
Human and animal rights
This article does not contain any experimental studies with human participants or animals performed by any of the authors.
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