Intraoperative Imaging in Hepatopancreatobiliary Surgery

Area of Science:

• Surgical Oncology
• Medical Imaging
• Gastroenterology

Background:

• Hepatopancreatobiliary (HPB) surgery is highly complex due to intricate anatomy and challenges in differentiating tumors from benign conditions.
• Current imaging modalities and intraoperative ultrasound offer some benefits but lack the precision needed for negative resection margins.
• Existing fluorescent dye techniques have limitations, and advanced methods like photoacoustic imaging are primarily preclinical.

Purpose of the Study:

• To review existing and emerging intraoperative imaging modalities for HPB cancers.
• To identify the need for ideal contrast agents to distinguish malignant from benign tissues.
• To explore the prognostic benefits of intraoperative imaging and its role in theranostics.

Main Methods:

• Comprehensive literature review of current and developing intraoperative imaging techniques in HPB surgery.
• Analysis of limitations and potential of various imaging modalities, including fluorescent dyes, photoacoustic imaging, and 3D holograms.
• Discussion on the development of contrast agents for improved tissue differentiation and theranostic applications.

Main Results:

• Significant challenges persist in achieving precise tumor margin identification in HPB surgery.
• Emerging imaging technologies show promise but require further development and clinical validation.
• There is a clear need for advanced contrast agents to enhance diagnostic accuracy during surgery.

Conclusions:

• Intraoperative imaging is essential for advancing HPB cancer surgery, demanding innovation in contrast agents and imaging techniques.
• Translating emerging technologies like photoacoustic imaging into routine clinical practice is a key future direction.
• Integrating imaging with theranostics offers potential for combined diagnosis and therapy in HPB oncology.