Modalities for image- and molecular-guided cancer surgery

Area of Science:

• Surgical Oncology
• Medical Imaging
• Molecular Guidance

Background:

• Surgery is crucial for solid tumor treatment, but surgeons primarily rely on visual and haptic cues.
• Preoperative imaging aids staging, yet intraoperative guidance can improve resection adequacy.
• Image and molecular guidance offer enhanced tumor definition and detection of aberrant deposits.

Purpose of the Study:

• To review intraoperative modalities for image- and molecular-guided cancer surgery.
• To compare these techniques based on predefined characteristics.
• To summarize available data using a rating scale for quantitative features.

Main Methods:

• Systematic literature search for peer-reviewed publications (January 2012 - January 2017).
• Identification and review of ten image- and molecular-guided surgery techniques.
• Comparison based on 25 characteristics and a three-point rating scale.

Main Results:

• Ten techniques identified, categorized into conventional, optical, nuclear, and endogenous reflectance modalities.
• Conventional imaging has defined resolution and long acquisition times.
• Optical imaging offers real-time visualization but limited penetration; nuclear modalities have deep penetration but use radioactivity; endogenous reflectance provides high resolution with a narrow field of view.

Conclusions:

• No single intraoperative modality is universally suitable for all cancer surgeries.
• Each technique has distinct strengths and weaknesses.
• Optimal surgical outcomes require careful selection and potential combination of modalities based on cancer type and surgical needs.