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We evaluated the technical feasibility of combining light detection and ranging (LiDAR)-registered freehand SPECT (\n                      <jats:italic>fh<\/jats:italic>\n                      SPECT) with near-infrared (NIR) fluorescence imaging for spatially augmented localisation of hybrid tracer uptake in solitary SNs and SNs residing within ILND specimens.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fourteen patients with penile cancer (25 cN0 groins; 3 cN1 groins) underwent radio- and fluorescence-guided lymph node (LN) surgery following preoperative lymphoscintigraphy and SPECT\/CT. Resected specimens underwent conventional ex vivo assessment, followed by LiDAR-registered\n                      <jats:italic>fh<\/jats:italic>\n                      SPECT with co-registered NIR-fluorescence imaging. These 3D models were compared with conventional ex vivo assessments, preoperative imaging, and histopathological outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 40 solitary tracer-avid LNs and 3 ILND specimens underwent ex vivo assessment. LiDAR\/\n                      <jats:italic>fh<\/jats:italic>\n                      SPECT localised radioactive hotspots in 38\/40 solitary LNs, consistent with conventional gamma probe assessment, while both conventional and LiDAR-registered NIR-fluorescence imaging detected fluorescent signal in all 40 LNs. Among the 3 ILND procedures, preoperative SPECT\/CT identified 6 tracer-avid hotspots within the anatomical resection template. Conventional gamma probe and NIR-fluorescence detected only 4 and 5 hotspots, respectively, whereas LiDAR\/\n                      <jats:italic>fh<\/jats:italic>\n                      SPECT localised all 6 hotspots in the corresponding resected specimens. Histopathology identified 6 tumour-positive LNs, all of which were hybrid tracer-avid and effectively localised by LiDAR\/\n                      <jats:italic>fh<\/jats:italic>\n                      SPECT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LiDAR-registered 3D surface mapping provided anatomical context to radioactive and fluorescent molecular imaging signals, enabling localisation of tracer-avid LNs in complex ex vivo ILND specimens. These findings support the feasibility of spatially augmented localisation of hybrid tracer uptake and warrant validation in larger studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-08075-y","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T02:20:31Z","timestamp":1784600431000},"page":"7180-7193","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["LiDAR-registered freehand SPECT combined with NIR-fluorescence enables spatial localisation of tracer-avid inguinal lymph nodes: A clinical feasibility study"],"prefix":"10.1007","volume":"53","author":[{"given":"Rick W. 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Eur J Nucl Med Mol Imaging. 2025. https:\/\/doi.org\/10.1007\/s00259-025-07708-y.","journal-title":"Eur J Nucl Med Mol Imaging"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-08075-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-026-08075-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-08075-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T08:31:48Z","timestamp":1790929908000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-026-08075-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":38,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["8075"],"URL":"https:\/\/doi.org\/10.1007\/s00259-026-08075-y","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"assertion":[{"value":"24 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This prospective feasibility study was approved by the Institutional Review Board of the Antoni van Leeuwenhoek Hospital (NCI-AVL) (IRBdm24-249). Informed consent was obtained from all individual participants included in the study.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images in Fig.\u00a0\n                      \n                      .","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}