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Precision Surgery Guided by Intraoperative Molecular Imaging.

Feredun Azari¹, Kevin Zhang², Gregory T Kennedy¹

¹Department of Thoracic Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine

|August 11, 2022

Summary

Intraoperative molecular imaging (IMI) enhances cancer surgery by enabling real-time assessment of tumor margins and disease detection. This advanced technique improves surgical outcomes and reduces cancer recurrence.

Keywords:

NIR fluorochrome intraoperative molecular imaging optical biopsy precision guided surgery

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Area of Science:

Oncology
Surgical Oncology
Molecular Imaging

Background:

Intraoperative molecular imaging (IMI) is a rapidly advancing field in surgical oncology.
IMI provides real-time assessment of oncologic resection quality, margin status, and detection of occult disease during surgery.

Approach:

Development of novel fluorescent tracers that target tumor-specific characteristics.
Overcoming limitations of autofluorescence and depth penetration with hybrid radioactive/fluorescent tracers and near-infrared (NIR-II) imaging.

Key Points:

Fluorochromes exploit tumor microenvironment properties like leaky vasculature and receptor overexpression.
IMI applications are expanding across various cancer types.
Demonstrated improvements in reducing cancer recurrence and enhancing patient outcomes.

Conclusions:

IMI offers significant benefits in cancer surgery without increasing clinical or patient burden.
Future directions include further refinement of tracers and imaging technologies for broader oncologic applications.