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Fluorescence-Guided Robotic Surgery

Description

Recent breakthrough developments in the field of targeted radiotracers are now enabling the detection of prostatic tissue in lymph nodes using PET-CT or PET-MRI imaging. These radiotracers target the prostate-specific membrane antigen (PSMA), a membrane-bound receptor which is highly upregulated in all stages of prostate cancer. To date, however, it is still challenging to remove these lesions as diagnostic knowledge cannot be used for a precise therapy in a straight forward manner. Instead, diagnostic images must be mentally fused with the partially visible anatomy. This approach is associated with a high level of uncertainty and requires a lot of experience, especially in the presence of organ deformation. The aim of this multidisciplinary research project is to investigate the feasibility of computer-assisted fluorescence-guided surgery using prostate-specific membrane antigen (PSMA)-targeted imaging probes. The main scientific contributions so far are related to intra-operative data fusion using fluorescent structures [4-7] as well as the development of a fluorescent PSMA-based dye [2,3].

Key collaborators

  • PD Dr. Dogu Teber and Dr. Tobi Simpfendörfer
    University of Heidelberg, Department of Urology

  • Prof. Dr. Klaus Kopka
    German Cancer Research Center (DKFZ), Division of Radiopharmaceutical Chemistry

  • Dr. Jonathan Sorger
    Intuitive Surgical, Inc.


  • Dr. Hannes Kenngott
    University of Heidelberg, Division of Minimally-invasive Surgery of the Department of General Surgery


  • Dr. Arianeb Mehrabi, 
    University of Heidelberg, Division of Visceral Surgery of the Department of General Surgery

Funding

Partial funding from Intuitive Surgical, Inc., in the form of equipment and hardware support.

Publications

  1. Majlesara A, Golriz M, Hafezi M, Saffari A, Stenau E, Maier-Hein L, Müller-Stich BP, Mehrabi A. Indocyanine green fluorescence imaging in hepatobiliary surgery. Photodiagnosis and Photodynamic Therapy. 2017;17:208-15.
  2. Baranski A-C, Schäfer M, Bauder-Wüst U, Roscher M, Schmidt J, Stenau E, Simpfendörfer T, Teber D, Maier-Hein L, Hadaschik B, Haberkorn U, Eder M, Kopka K. PSMA-11 Derived Dual-labeled PSMA-Inhibitors for Preoperative PET Imaging and Precise Fluorescence-Guided Surgery of Prostate Cancer. Journal of Nuclear Medicine. 2017 Nov 30;jnumed.117.201293
  3. Baranski A-C, Schaefer M, Bauder-Wuest U, Roscher M, Schmidt J, Stenau E, Simpfendoerfer T, Maier-Hein L, Hadaschik B, Haberkorn U, Eder M, Kopka K. Preclinical evaluation of dual-labeled PSMA-inhibitors for the diagnosis and therapy of prostate cancer. Journal of Nuclear Medicine. 2017;58(supplement 1):531-531.
  4. Stenau E, Simpfendörfer T, Azizian M, Liu W, Anderson KK, Bergman D, Mohareri O, Sorger JM, Teber D and Maier-Hein L. In vivo robustness analyses of intraoperative registration with fluorescent markers. In: International Society for Computer Aided Surgery. 2017.
  5. Wild E, Teber D, Schmid D, Simpfendörfer T, Müller M, Baranski A-C, Kenngott H, Kopka K, Maier-Hein L. Robust augmented reality guidance with fluorescent markers in laparoscopic surgery. International Journal of Computer Assisted Radiology and Surgery. 2016;11(6):899-907.
  6. Wild E, Teber D, Schmid D, Simpfendörfer T, Müller M, Kenngott, H. und Maier-Hein L. Robuste intraoperative Registrierung mit fluoreszierenden Markern für die computergestützte Laparoskopie. In: Bildverarbeitung für die Medizin (BVM). 2016.
  7. Maier-Hein L, Wild E and Teber D. System for fluorescence aided surgery. EP 15 193 169.8. 

Awards

  • ISCAS Koh Young Young Investigator Best Paper Award (2017)
    International Congress and Exhibition on Computer Assisted Radiology and Surgery (CARS)
    E. Stenau et al., for the paper "In vivo robustness analyses of intraoperative registration with fluorecent markers."

  • 2017 Henry N. Wagner, Jr, MD, Image of the Year Award
    A.C. Baranski, ..., E. Stenau et al. for the abstract image used in "Preclinical evaluation of dual-labeled PSMA-inhibitors for the diagnosis and therapy of prostata cancer."
  • Philips / IPCAI Audience Best Paper Award (2016)
    E. Wild et al., for the paper, "Robust Augmented Reality Guidance with Fluorescent Markers in Laparoscopic Surgery."

  • PhD Poster Presentation Award (2016)
    DKFZ Heidelberg
    E. Wild, "Robust augmented reality guidance with fluorescent markers in laparoscopic surgery."

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