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Published on: September 19, 2014
Fundamentals and developments in fluorescence-guided cancer surgery
J Sven D Mieog1, Friso B Achterberg1,2, Aimen Zlitni2
1Department of Surgery, Leiden University Medical Center, Leiden, Netherlands.
Abstract:
Fluorescence-guided surgery using tumour-targeted imaging agents has emerged over the past decade as a promising and effective method of intraoperative cancer detection. An impressive number of fluorescently labelled antibodies, peptides, particles and other molecules related to cancer hallmarks have been developed for the illumination of target lesions. New approaches are being implemented to translate these imaging agents into the clinic, although only a few have made it past early-phase clinical trials. For this translational process to succeed, target selection, imaging agents and their related detection systems and clinical implementation have to operate in perfect harmony to enable real-time intraoperative visualization that can benefit patients. Herein, we review key aspects of this imaging cascade and focus on imaging approaches and methods that have helped to shed new light onto the field of intraoperative fluorescence-guided cancer surgery with the singular goal of improving patient outcomes.
Insights
Fluorescence-guided surgery uses targeted imaging agents for real-time intraoperative cancer detection. Optimizing this approach requires seamless integration of targets, agents, and systems to improve patient outcomes.
Area of Science:
- Oncology
- Medical Imaging
- Surgical Technology
Background:
- Fluorescence-guided surgery (FGS) is a rapidly advancing technique for intraoperative cancer detection.
- Numerous fluorescently labeled molecules targeting cancer hallmarks have been developed.
- Translating these agents into clinical practice faces challenges, with few reaching advanced trials.
Purpose of the Study:
- To review the key aspects of the fluorescence-guided surgery imaging cascade.
- To focus on imaging approaches and methods enhancing intraoperative visualization.
- To highlight advancements aimed at improving patient outcomes in cancer surgery.
Main Methods:
- Review of current literature on fluorescence-guided surgery.
- Analysis of imaging agents, target selection, and detection systems.
- Discussion of clinical implementation strategies for intraoperative visualization.
Main Results:
- Development of diverse fluorescent imaging agents targeting cancer hallmarks.
- Identification of critical factors for successful clinical translation of FGS.
- Emerging approaches for real-time intraoperative visualization.
Conclusions:
- Successful clinical implementation of FGS depends on harmonized target selection, imaging agents, and detection systems.
- Continued research and development are crucial for advancing FGS.
- The ultimate goal is to improve patient outcomes through enhanced intraoperative cancer detection.
