在降落式无线指导手术期间,对信号与背景比率的可操作反
Berkay A Cakal1,2,3, Kateryna Pirkovets1,4, Vera A Ottens1,4
1Interventional Molecular Imaging Laboratory, Leiden University Medical Centre, Leiden, The Netherlands.
概括
在前列腺特异性膜抗原 (PSMA) 向放射导向手术 (RGS) 期间实时信号与背景比 (SBR) 反提高了手术感知和效率. 这种增强的反系统集成到机器人控制台中,有助于更好地区分癌症病变.
科学领域:
- 核医学和外科瘤学.
- 最少入侵的机器人手术
- 分子成像和诊断分子成像和诊断
背景情况:
- 使用前列腺特异性膜抗原 (PSMA) 向标记物的放射导向手术 (RGS) 面临着低内科手术信号强度的挑战.
- 有限的信号强度阻碍了基于手术期间每秒钟探针计数的准确目标区分.
- 现有的方法缺乏实时对比信息,增加了外科医生的认知负载.
研究的目的:
- 评估实时信号与背景比率 (SBR) 反是否能改善PSMA目标的RGS中的外科感知,决策能力和扫描效率.
- 评估将图形用户界面 (GUI) 集成到机器人控制台中,用于实时SBR反.
- 为了确定SBR反对探头处理和在救援RGS程序期间目标歧视的影响.
主要方法:
- 从TRACE-II试验中接受99mTc-PSMA救援RGS的10名患者的回顾性分析.
- 通过GUI (实验) 进行标准每秒计数反 (控制) 和实时SBR反之间的比较.
- 使用总和目标扫描持续时间量化扫描性能,通过视频跟踪重建探头轨迹.
主要成果:
- 14个PSMA-avid病变被成功切除并确认为癌症.
- 实时SBR反组显示,总扫描持续时间 (455秒到237秒) 和目标扫描持续时间 (299秒到212秒) 的中位数减少.
- 在SBR反 (21.1到5.3秒/秒) 的情况下,正常化的中位数目标扫描持续时间显著下降,这表明效率有所提高.
结论:
- 将实时SBR反流入机器人控制台可以提高PSMA-RGS手术感知和决策能力.
- 集成于GUI的SBR反将对比信息数字化,减少认知负载并改善目标歧视.
- 这些发现支持进一步的多中心研究,以建立基于SBR的标准化RGS性能指标.
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