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@ARTICLE{Moraitis:298597,
      author       = {A. Moraitis$^*$ and T. Kahl$^*$ and J. Kandziora$^*$ and W.
                      Jentzen$^*$ and D. Kersting$^*$ and L. Püllen$^*$ and H.
                      Reis and J. Köllermann and C. Kesch$^*$ and U. Krafft$^*$
                      and B. A. Hadaschik$^*$ and H. Zaidi and K. Herrmann$^*$ and
                      F. Barbato$^*$ and W. P. Fendler$^*$ and C. Darr$^*$ and P.
                      Fragoso Costa$^*$},
      title        = {{E}valuation of {S}urgical {M}argins with {I}ntraoperative
                      {PSMA} {PET}/{CT} and {T}heir {P}rognostic {V}alue in
                      {R}adical {P}rostatectomy.},
      journal      = {Journal of nuclear medicine},
      volume       = {66},
      number       = {3},
      issn         = {0097-9058},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2025-00307},
      pages        = {352-358},
      year         = {2025},
      note         = {2025 Mar 3;66(3):352-358},
      abstract     = {Detection of positive resection margins in surgical
                      procedures of high-risk prostate cancer is key for
                      minimizing the risk of recurrence. This study aimed at
                      evaluating the accuracy of functional tumor-volume
                      segmentation in intraoperative ex vivo PET/CT for margin
                      assessment in prostate cancer patients undergoing radical
                      prostatectomy. Methods: Seven high-risk prostate cancer
                      patients received [18F]PSMA-1007 before radical
                      prostatectomy. After removal of the prostate gland, ex vivo
                      imaging on the AURA 10 PET/CT system was performed, and
                      functional tumor volume was segmented using 4 semiautomatic
                      segmentation methods. Resection margins and volumes were
                      compared with histopathology. Additionally, a supportive
                      phantom study was conducted to assess segmentation accuracy
                      at low radiopharmaceutical activity. Results: Clinically, 18
                      lesions were analyzed in intraoperative PET/CT. Sensitivity,
                      specificity, and positive and negative predictive values of
                      margin detection were $83\%,$ $100\%,$ $100\%,$ and $92\%,$
                      respectively, using an iterative thresholding method. In 1
                      patient, a biochemical recurrence was observed within 1 y of
                      prostate-specific antigen follow-up, and 1 patient underwent
                      adjuvant radiotherapy. The remaining 5 patients were still
                      undergoing prostate-specific antigen follow-up with no
                      evidence of biochemical recurrence. On the basis of a
                      phantom-deduced minimal segmentable activity concentration
                      of approximately 2 kBq/mL, we propose an administered
                      [18F]PSMA-1007 activity of at least 1.9 and 0.4 MBq/kg for
                      preoperative and intraoperative injections, respectively.
                      Conclusion: Intraoperative ex vivo PET/CT is a promising
                      modality for intraoperative margin assessment. Prospective
                      trials are needed to further investigate the value of
                      specimen PET/CT-based radioguided surgery in high-risk
                      prostate cancer.},
      keywords     = {PET/CT (Other) / margin assessment (Other) / prostate
                      cancer (Other) / radical prostatectomy (Other) / radioguided
                      surgery (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39915125},
      doi          = {10.2967/jnumed.124.268719},
      url          = {https://inrepo02.dkfz.de/record/298597},
}