Diese Seite wurde automatisch übersetzt und die Genauigkeit der Übersetzung wird nicht garantiert. Bitte wende dich an die englische Version für einen Quelltext.

SPECTRA: Intraoperative Hyperspectral Imaging for Prostate Cancer (SPECTRA)

14. September 2026 aktualisiert von: Massimo Valerio

Radical prostatectomy (RP) is currently one of the gold standard of care in managing localized prostate cancer (Pca). However, despite advances in Robot-Assisted RP (RARP), cancer cells may still be found (up to 42%) at the edge of the removed prostate specimen, commonly referred as Positive Surgical Margins (PSM). PSM are well-known risk factors of adverse oncological outcomes (biochemical recurrence).

It is therefore essential to characterize intraoperatively the tumor extent. In RARP, the leading intraoperative margin assessment (IMA) technique, NeuroSAFE is based on Intra-operative frozen section (IFS) of both prostate lateral sides sampled at 3-5 mm intervals. However, despite proven oncological benefit, adoption is still limited to expert centers due to a prolonged operative time, loss of integrity of the surgical specimen for definitive histopathological analysis, omission of regions (apex, base), and logistical complexity (trained uropathologist, cryostat…).

With this prospective single-center project, we wish to explore the use of non-invasive optical imaging technology, HyperSpectral Imaging (HSI), as a reliable alternative for examination of the ex-vivo prostate specimen to

  1. Distinguish normal versus tumor tissue at the surgical margin in fresh specimen.
  2. Quantify whether HSI can be integrated into the intraoperative workflow (feasibility), thus, image acquisition time and inference time should then be evaluated.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Prostate cancer (Pca) is the second most frequently diagnosed cancer in men worldwide with over 1.5 million new cases annually and a median age at diagnosis of 66 years. Despite the natural history being slow and clinically insignificant in most cases, its heterogeneity and high prevalence mean it remains the second leading cause of cancer-related death worldwide. Treatment options depend on cancer stage, risk stratification and patient preferences.

Radical prostatectomy (RP), which consists of the surgical removal of the prostate and the seminal vesicles, is one of the gold-standard curative treatment for localized diseases. RP techniques include open, laparoscopic, and robotic-assisted surgery. Despite recent advances in the robotic field, positive surgical margins (PSM) can occur up to 42 %. According to the International Society of Urological Pathology (ISUP), PSM is defined by tumor cells reaching the inked surgical margin of the prostatectomy specimen. PSM significantly reduces progression-free survival and is a known prognostic parameter for postoperative biochemical recurrence (BCR).

Current margin assessment relies on Intraoperative Frozen Section (IFS), the current gold-standard technique is the Neurovascular Structure-Adjacent Frozen-Section Examination (NeuroSAFE). It consists of an IFS analysis of tissue adjacent to neurovascular bundles. While this neurovascular structure sparing method improves postoperative erectile function and reduces PSM, its implementation is limited due to additional operating time (45-60 minutes), increased resource demands on pathology departments, and the inability to provide a whole specimen analysis.

Hyperspectral Imaging (HSI) combines conventional imaging (camera) with a spectrometer, providing both spatial and spectral information of the analyzed structures, enabling tissue differentiation based on structural properties. HSI uses reflectance spectroscopic imaging measurements, which involve a white light irradiation of the tissue and subsequently a recording of the remitted spectral intensities. The interaction between the incident light and the tissue modifies the light's spectral distribution with the reflected light containing information about the tissue composition. This technology has already been successfully applied in visceral surgery to quantify liver viability during ischemic and reperfusion phases. More recently, in Urology, HSI was successfully used as a predictive tool for early postoperative kidney graft.

Another clinical application of HSI is the ability to discriminate between normal and cancerous tissue as observed in gastric, head and neck (H&N), colorectal, brain and breast cancers. Similarly, in 2024, spectral data from Diffuse Reflectance Spectroscopy (DRS) showed promising results achieving an average sensitivity of 89% with a specificity of 82%, in 59 prostatectomy specimens, confirming the potential of spectroscopy. However, DRS approach comes with limitations, more particularly in spatial orientation because it requires multiple point-based measurements across the prostate surface with the inability to evaluate the entire tissue volume. In contrast, HSI provides spatially resolved spectral data across the entire field of view, enabling comprehensive tissue mapping. In 2012, the feasibility of HSI for PCa detection was evaluated in in-vivo mice and in pathological tissue slides, achieving 93% sensitivity and 97% specificity using a support vector machine algorithm and providing an estimated AUC-ROC of 0.9485. In this context, HSI provides a unique opportunity to assess fully a specimen. However, its application for real-time margin assessment during surgery remains unexplored. Recently, a 3D pipeline that co-registers multi-angle ex-vivo HSI with volumetric histopathology was implemented, enabling voxel-wise tumor segmentation and AR visualization in H&N specimens using convolutional neural networks (CNNs).

This project aims to validate HSI feasibility in ex-vivo prostate specimens. By providing a non-invasive and contactless evaluation in the operating theatre, HSI could reduce PSM rates, minimizing adjuvant radiotherapy needs and overall, improve long-term oncological outcomes.

In this research project, the TIVITA® Tissue system, a CMOS (Complementary Metal Oxide Semiconductor) Push-broom Scanning Hyperspectral Camera device, designed for real-time tissue assessment, will be employed. This CE (Conformité Européenne) certified device can provide 640x480 pixel images with a spectral range of 500 to 1000 nm and a spectral resolution of 5nm. The illumination system consists in six 20 W halogen spotlights (OSRAM GmbH, Munich, Germany). Each measurement takes approximately 7 seconds with a measured area up to 20-30 cm (wide enough for a whole prostate specimen).

Studientyp

Interventionell

Einschreibung (Geschätzt)

26

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

Studienorte

    • Canton of Geneva
      • Geneva, Canton of Geneva, Schweiz, 1205
        • Rekrutierung
        • Hôpitaux Universitaires de Genève - Dept de Chirurgie - Service d'Urologie
        • Kontakt:
        • Kontakt:
        • Hauptermittler:
          • Massimo Valerio, Prof Dr med
        • Unterermittler:
          • Jean-Christophe Tille, MD
        • Unterermittler:
          • Oliver Windisch, MD
        • Unterermittler:
          • Michele Diana, Prof Dr med
        • Unterermittler:
          • Doron Merkler, Prof Dr med
        • Unterermittler:
          • Mario Kreutzfeldt, MD
        • Unterermittler:
          • Andrew Janawczyk, Prof Dr med
        • Unterermittler:
          • Vincent Benard, Resident
        • Unterermittler:
          • Christian Lovis, Prof Dr med
        • Unterermittler:
          • Mina Bjelogrlic, PhD

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  • Histological diagnosis (biopsy) of Pca
  • Prostate volume < 100 cm3 (measured on preoperative MRI) for a smooth acquisition with the hyperspectral device
  • Capable of forming his own views

Exclusion Criteria:

  • Unwilling to participate.
  • Inability to follow study procedures, for example due to language problems, psychological disorders, dementia, etc.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Diagnose
  • Zuteilung: N / A
  • Interventionsmodell: Einzelgruppenzuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Participants with prostate cancer undergoing robot-assisted prostatectomy. HyperSpectral imaging.

One visit related to the research protocol which consists in the information consultation during which the participant receives detailed oral and written information.

RAPR (day 0) is performed according to standard practice and is not part of the research-specific procedure.

The study is then based solely on ex-vivo analysis.

The study specific specimen handling consists in a multi-Angle HSI Image Acquisition before routine pathology. To enhance the co-registration between the two modalities, a black-ink may be applied on the ex-vivo specimen based on a MRI suspicious region of extra-prostatic extension (EPE Grade ≥ 2).

This procedure follows prior robust registration work between ex-vivo HSI and histology evaluation. The identification of this region will rely on the standard pre-operative MRI review already performed as part of routine care within our prostate cancer center before each radical prostatectomy.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Tumor extent
Zeitfenster: HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Dice similarity coefficient between HSI-derived and histopathology spatial overlap between the HSI tumor map and co-registered histopathology
HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Boundary delineation
Zeitfenster: HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Normalized surface distance between HSI-derived andhistopathological tumor contours. Contour agreement
HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Region overlap
Zeitfenster: HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Jaccard index between HSI-derived and histopathological tumor masks intersection over union
HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Foreground discrimination
Zeitfenster: HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Pixel-wise sensitivity of HSI for tumor classification. Proportion of histologically tumor-positive pixels classified as tumor
HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Background discrimination
Zeitfenster: HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Pixel-wise specificity of HSI for tumor classification . Proportion of histologically non-tumor pixels classified as non-tumor
HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Overall agreement:
Zeitfenster: HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Pixel-wise accuracy of HSI for tumor classification. Proportion of evaluated pixels correctly classified, histopathology as reference
HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Clinical workflow
Zeitfenster: HSI acquisition on Day 0 (day of surgery)
HSI acquisition time
HSI acquisition on Day 0 (day of surgery)
Computational runtime
Zeitfenster: HSI acquisition on Day 0 (day of surgery)
Mean model inference time per hyperspectral image
HSI acquisition on Day 0 (day of surgery)

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Surgical margins
Zeitfenster: HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7
Diagnostic accuracy of HSI for detection of histologically positive margins
HSI acquisition on Day 0 (day of surgery); reference histopathological assessment on postoperative Days 7

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Massimo Valerio, HUG

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. August 2026

Primärer Abschluss (Geschätzt)

31. August 2027

Studienabschluss (Geschätzt)

31. Dezember 2027

Studienanmeldedaten

Zuerst eingereicht

31. August 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

14. September 2026

Zuerst gepostet (Tatsächlich)

17. September 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

17. September 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

14. September 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • 2026-00595

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Beschreibung des IPD-Plans

Exploratory study with a small number of participants.

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .