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Updated: Sep 15, 2025
Computed Tomography-guided Time-domain Diffuse Fluorescence Tomography in Small Animals for Localization of Cancer Biomarkers
Published on: July 17, 2012
Translational contrast agents for use in fluorescence image-guided tumor surgery
Da-Yong Hou1, Xiang-Peng Li2, Yue-Ze Wang3
1NHC Key Laboratory of Molecular Probe and Targeted Theranostics, Harbin Medical University, Harbin, 150001, China; Department of PET-CT/MRI, Harbin Medical University Cancer Hospital, Harbin, 150001, China; Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Sai Ying Pun, 999077, Hong Kong, China.
Abstract:
Currently, surgical intervention remains the foundation in curing most solid tumors. Over the past few decades, even with rapid intraoperative tissue pathology assessment, the overall rate of positive surgical margins for tumors stagnated between 15 % and 60 %. The increased local recurrence rates and poor prognoses associated with various cancers, such as head and neck, brain, breast, lung, prostate, and gastrointestinal cancers, are linked to positive margins. Recently, driven by the concept of precise surgery, significant advancements have been reported in the intraoperative use of fluorescent contrast agents in the field of surgery. Molecular imaging via intraoperative fluorescence plays a guiding role in surgery, providing surgeons with visible fluorescent images. In clinical applications, fluorescent contrast agents can clearly delineate tumor boundaries, offering high recognition capacities and real-time guidance during surgery. Additionally, they can localize lymph node metastases, detect small metastatic lesions, and identify critical anatomical structures during surgery, thus reducing the risk of collateral damage. An ideal surgical guidance technology should lack radiation and display a high sensitivity and good resolution and an adjustable field of view, with rapid imaging. Enhancing the tissue penetration of fluorescence and targeting capacities of molecular probes are critical in providing more comprehensive tumor-related data. Additionally, screening and identifying other tumor biomarkers and more of their corresponding targeted molecular data are essential in enhancing the specificity of molecular imaging. Finally, the investigation and use of a wider range of near-infrared fluorescent dyes with improved biocompatibilities and imaging are critical in designing synthetic probes for application in intraoperative navigation. The development of novel, efficient, safe fluorescent contrast agents is a critical direction in current pharmaceutical research and development.
Insights
Intraoperative fluorescence imaging using novel contrast agents can improve tumor margin detection, reducing cancer recurrence. This technology offers real-time surgical guidance, enhancing precision and patient outcomes in various cancer surgeries.
Area of Science:
- Surgical Oncology
- Medical Imaging
- Pharmaceutical Research
Background:
- Positive surgical margins remain a significant challenge in solid tumor treatment, leading to increased local recurrence and poorer prognoses across various cancers.
- Existing intraoperative tissue assessment methods have not substantially improved positive margin rates, which persist between 15% and 60%.
Purpose of the Study:
- To explore advancements in intraoperative fluorescence imaging for precise tumor delineation and surgical guidance.
- To highlight the role of novel fluorescent contrast agents in improving surgical outcomes by enhancing tumor boundary recognition and reducing collateral damage.
Main Methods:
- Review of recent developments in molecular imaging and fluorescent contrast agents for intraoperative applications.
- Discussion of the characteristics of ideal surgical guidance technology, including sensitivity, resolution, and imaging speed.
- Emphasis on enhancing fluorescence tissue penetration, molecular probe targeting, and the use of near-infrared fluorescent dyes.
Main Results:
- Intraoperative fluorescence imaging provides real-time visual guidance, enabling clear delineation of tumor boundaries.
- Fluorescent contrast agents aid in localizing lymph node metastases, detecting small lesions, and identifying critical anatomical structures.
- This technology has the potential to significantly reduce positive surgical margins and improve surgical precision.
Conclusions:
- Novel, efficient, and safe fluorescent contrast agents are crucial for advancing intraoperative navigation and precise surgery.
- Continued research into enhancing fluorescence properties and molecular targeting is essential for comprehensive tumor data acquisition and improved specificity.
- The development of these agents represents a critical direction in pharmaceutical research and development for oncologic surgery.
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