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Fluorescence Guidance in Surgical Oncology: Challenges, Opportunities, and Translation

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Abstract

Surgical resection continues to function as the primary treatment option for most solid tumors. However, the detection of cancerous tissue remains predominantly subjective and reliant on the expertise of the surgeon. Surgery that is guided by fluorescence imaging has shown clinical relevance as a new approach to detecting the primary tumor, tumor margins, and metastatic lymph nodes. It is a technique to reduce recurrence and increase the possibility of a curative resection. While significant progress has been made in developing this emerging technology as a tool to assist the surgeon, further improvements are still necessary. Refining imaging agents and tumor targeting strategies to be a precise and reliable surgical strategy is essential in order to translate this technology into patient care settings. This review seeks to provide a comprehensive update on the most recent progress of fluorescence-guided surgery and its translation into the clinic. By highlighting the current status and recent developments of fluorescence image-guided surgery in the field of surgical oncology, we aim to offer insight into the challenges and opportunities that require further investigation.

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Acknowledgements

This work was supported in part by the National Institutes of Health [grant numbers R01EB019449, R00CA153916, P20 GM103480, and P30CA036727 (Fred and Pamela Buffett Cancer Center at UNMC)], the Nebraska Cattlemen’s Ball Development Fund, and the Nebraska Research Initiative.

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Authors and Affiliations

  1. Eppley Institute for Research in Cancer and Allied Diseases, University of Nebraska Medical Center, Omaha, NE, 68198, USA

    Madeline T. Olson

  2. Fred and Pamela Buffet Cancer Center, University of Nebraska Medical Center, Omaha, NE, 68198, USA

    Madeline T. Olson, Quan P. Ly & Aaron M. Mohs

  3. Department of Surgery, University of Nebraska Medical Center, Omaha, NE, 68198, USA

    Quan P. Ly

  4. Department of Pharmaceutical Sciences, University of Nebraska Medical Center, 5-12315 Scott Research Tower, Omaha, NE, 68198, USA

    Aaron M. Mohs

  5. Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE, 68198, USA

    Aaron M. Mohs

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  1. Madeline T. Olson
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Correspondence to Aaron M. Mohs.

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Conflict of Interest

A.M.M. is a co-inventor of image-guided surgery technology that is licensed to Spectropath, Inc. (Atlanta, GA).

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Olson, M.T., Ly, Q.P. & Mohs, A.M. Fluorescence Guidance in Surgical Oncology: Challenges, Opportunities, and Translation. Mol Imaging Biol 21, 200–218 (2019). https://doi.org/10.1007/s11307-018-1239-2

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