Background: To examine the feasibility and safety of the SENSEI®drop-in gamma probe for robot-assisted, prostate-specific membrane antigen (PSMA)-radioguided salvage surgery (RGS) in lymph node or local oligorecurrent prostate cancer (PCa), detected via PSMA positron emission tomography/computed tomography (PET/CT). Methods: The first thirteen patients with pelvic oligorecurrent PCa who underwent [99mTc]Tc-PSMA-I&S RGS using the SENSEI®drop-in gamma probe at the Martini-Klinik (February–June 2024) were retrospectively analyzed. Radioactivity measurements in counts per second (CPS) as absolute values or ratios (CPS of tumor specimens/mean CPS from the patients’ benign tissues) were correlated with preoperative imaging and pathological findings (benign/malignant, lesion size). Postoperative complete biochemical response (cBR) was defined as prostate-specific antigen (PSA) levels of <0.2 ng/mL. Results: Fifty-four specimens were removed from 13 patients, with nineteen (35%) containing PCa. All patients had one PSMA PET/CT-positive lesion, which were all detected intraoperatively. These lesions showed higher ex vivo CPS, CPS ratios, and larger cancer diameters than PSMA PET/CT-negative lesions (allp< 0.05). Cancer-containing specimens exhibited higher CPS and CPS ratios than benign tissues (median values of 45 vs. 3, and 9.9 vs. 1.0, bothp< 0.001). In total, 12/13 (92%) patients achieved cBR. Conclusions: This device yielded excellent detection rates with good correlation to preoperative imaging and histological results without adverse events.
背景：本研究旨在探讨SENSEI®术中伽马探针用于机器人辅助前列腺特异性膜抗原（PSMA）放射性引导挽救性手术（RGS）治疗淋巴结或局部寡复发前列腺癌（PCa）的可行性与安全性，所有病例均通过PSMA正电子发射断层扫描/计算机断层扫描（PET/CT）检测确诊。 方法：回顾性分析2024年2月至6月期间在Martini-Klinik接受[99mTc]Tc-PSMA-I&S RGS并使用SENSEI®术中伽马探针治疗的首13例盆腔寡复发PCa患者。以每秒计数（CPS）为单位的放射性测量值（绝对值或比值，即肿瘤标本CPS/患者良性组织平均CPS）与术前影像学及病理结果（良性/恶性、病灶大小）进行相关性分析。术后完全生化缓解（cBR）定义为前列腺特异性抗原（PSA）水平<0.2 ng/mL。 结果：13例患者共切除54份标本，其中19份（35%）含有PCa。所有患者均存在一处PSMA PET/CT阳性病灶，且均在术中被成功检出。与PSMA PET/CT阴性病灶相比，这些病灶离体CPS值、CPS比值及癌灶直径均显著更高（所有p<0.05）。含癌标本的CPS及CPS比值均高于良性组织（中位值分别为45 vs. 3，9.9 vs. 1.0，均p<0.001）。总体而言，12/13（92%）例患者达到cBR。 结论：该设备展现出优异的检出率，与术前影像学及组织学结果具有良好相关性，且未发生不良事件。
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