PT  - JOURNAL ARTICLE
AU  - Philippa Meershoek
AU  - Gijs H. KleinJan
AU  - Matthias N. van Oosterom
AU  - Esther M.K. Wit
AU  - Danny M. van Willigen
AU  - Kevin P. Bauwens
AU  - Erik J. van Gennep
AU  - Alexandre M. Mottrie
AU  - Henk G. van der Poel
AU  - Fijs W.B. van Leeuwen
TI  - Multispectral-Fluorescence Imaging as a Tool to Separate Healthy from Disease-Related Lymphatic Anatomy During Robot-Assisted Laparoscopy
AID  - 10.2967/jnumed.118.211888
DP  - 2018 Nov 01
TA  - Journal of Nuclear Medicine
PG  - 1757--1760
VI  - 59
IP  - 11
4099  - http://jnm.snmjournals.org/content/59/11/1757.short
4100  - http://jnm.snmjournals.org/content/59/11/1757.full
SO  - J Nucl Med2018 Nov 01; 59
AB  - To reduce the invasive nature of extended pelvic lymph node (LN) dissections in prostate cancer, we have developed a multispectral-fluorescence guidance approach that enables discrimination between prostate-draining LNs and lower-limb–draining LNs. Methods: In 5 pigs, multispectral-fluorescence guidance was used on da Vinci Si and da Vinci Xi robots. The animals received fluorescein into the lower limb and indocyanine green–nanocolloid into the prostate. Results: Fluorescein was detected in 29 LNs (average of 3.6 LNs/template), and indocyanine green–nanocolloid was detected in 12 LNs (average of 1.2 LNs/template). Signal intensities appeared equal for both dyes, and no visual overlap in lymphatic drainage patterns was observed. Furthermore, fluorescein supported both the identification of leakage from damaged lymphatic structures and the identification of ureters. Conclusion: We demonstrated that the differences in lymphatic flow pattern between the prostate and lower limbs could be intraoperatively distinguished using multispectral-fluorescence imaging.