Molecular imaging assisted surgery improves survival in a murine head and neck cancer model

Surgery plays an important role in the treatment of head and neck cancer (HNC), and surgical margin status is a key prognostic factor. Molecular imaging (MI) can be applied to identify tumor extensions intraoperatively. We applied this technique in a murine HNC model to determine whether it improves outcomes from surgical intervention. An orthotopic murine model with HNC was established with SCC VII cells expressing a green fluorescent protein. To determine the diagnostic accuracy of MI, 20 murine models undergoing standard surgical resection were assessed with MI to identify residual tumor, which was compared to histology as the gold standard. Then, to assess the effect of MI as a therapeutic intervention for survival, 65 mice were randomly divided into standard surgical resection, MI-assisted surgical resection, and control groups. In the MI-assisted surgery group, residual signals identified by MI underwent further tissue excision to eliminate the signal positivity. In diagnostic accuracy analysis, sensitivity and specificity of intraoperative MI in the HNC murine model were 86% and 100%, respectively. The mice undergoing MI-assisted surgery showed a significantly improved 60-day survival rate compared to standard surgery, 37% versus 5%, respectively. Intraoperative MI guidance is a promising technique in oncologic surgery, which could increase the efficacy of tumor resection and the survival of patients with HNC. The hurdles in applying this technique in clinical practice are still considerable, and further research and development is warranted.