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Minimal-Invasive Robot-Assisted Image-Guided Resection of Prostate-Specific Membrane Antigen–Positive Lymph Nodes in Recurrent Prostate Cancer

van Leeuwen, Fijs W. B., PhD*†; van Oosterom, Matthias N., MSc*†; Meershoek, Philippa, BSc*†; van Leeuwen, Pim J., MD, PhD; Berliner, Christoph, MD; van der Poel, Henk G., MD, PhD; Graefen, Markus, MD, PhD§; Maurer, Tobias, MD, PhD§

doi: 10.1097/RLU.0000000000002600
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With the rapid expansion of robot-assisted surgical procedures, the need for robot-compliant image guidance technologies has also increased. Examples hereof are the integrated firefly fluorescence camera, the drop-in ultrasound probe, and the recently introduced DROP-IN gamma probe. Combined with 68Ga–prostate-specific membrane antigen–(PSMA)–11 PET/CT (staging) and 99mTc-PSMA-I&S SPECT/CT (preoperative imaging), the latter DROP-IN gamma probe technology recently allowed us to perform the first clinical cases of robot-assisted PSMA-guided salvage surgery of lymphatic metastases.

From the *Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden;

Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands;

Diagnostic and Interventional Radiology and Nuclear Medicine; and

§Martini-Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Received for publication December 7, 2018; revision accepted March 3, 2019.

Conflicts of interest and sources of funding: This research was supported by an NWO-TTW-VICI grant (TTW 16141). Material support was provided by Eurorad (Eurorad S.A., Eckbolsheim, France) supporting our study with a prototype DROP-IN gamma probe. None declared to all authors.

Correspondence to: Fijs W. B. van Leeuwen, PhD, Interventional Molecular Imaging Laboratory, Department of Radiology, C2-S zone, Leiden University Medical Center, Albinusdreef 2, 2300 RC Leiden, the Netherlands. E-mail:; or Tobias Maurer, MD, PhD, FEBU, Leitender Arzt, Universitätsklinikum Hamburg-Eppendorf, Martini-Klinik am UKE GmbH, Martinistraße 52 Gebäude Ost 46, 20246 Hamburg, Germany. E-mail:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Online date: May 17, 2019



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      PET; PSMA; molecular imaging; radioguided surgery; robot-assisted surgery; SPECT

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