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Molecular Imaging and Biology

, Volume 16, Issue 1, pp 1–9 | Cite as

Shifting Focus in Optical Image-Guided Cancer Therapy

  • Stijn KeereweerEmail author
  • Pieter B. A. A. Van Driel
  • Dominic J. Robinson
  • Clemens W. G. M. Lowik
Special Topics

Abstract

Cancer patients could benefit from a surgical procedure that helps the surgeon to determine adequate tumor resection margins. Systemic injection of tumor-specific fluorescence agents with subsequent intraoperative optical imaging can guide the surgeon in this process. However, tumor heterogeneity hampers tumor-specific targeting. In addition, determination of adequate resection margins can be very challenging due to invasive tumor strands that are difficult to resolve and because of the confounding effect of variations in tissue optical properties in the surgical margin. We provide an overview of the “classic approach” of imaging tumor-specific targets or tumor-associated pathophysiological processes, and explain the limitations of these targeting strategies. It is proposed that problems of tumor heterogeneity can theoretically be circumvented by shifting focus of tumor targeting towards the follicle-stimulating hormone receptor (FSHR). Furthermore, we discuss why objective determination of resection margins is required to improve resection of the invasive strands, a goal that may be achieved by targeting the FSHR. When invasive strands would nevertheless extend beyond such a standardized resection margin, we suggest that adjuvant photodynamic therapy would be a very suitable therapeutic regimen. Finally, we describe how point optical spectroscopy can be used to scrutinize suspect tissue that is difficult to differentiate from normal tissue by measuring the local tissue optical properties to recover a local intrinsic fluorescence measurement.

Key words

Optical imaging Image-guided therapy Follicle-stimulating hormone Cancer therapy Photodynamic therapy Point spectroscopy 

Notes

Acknowledgments

MTN is gratefully acknowledged for his supporting contribution during the writing process.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© World Molecular Imaging Society 2013

Authors and Affiliations

  • Stijn Keereweer
    • 1
    • 2
    Email author
  • Pieter B. A. A. Van Driel
    • 1
  • Dominic J. Robinson
    • 3
  • Clemens W. G. M. Lowik
    • 1
  1. 1.Department of Molecular ImagingLeiden University Medical CenterLeidenThe Netherlands
  2. 2.Department of Otorhinolaryngology-Head and Neck SurgeryErasmus Medical CenterRotterdamThe Netherlands
  3. 3.Center for Optical Diagnostics and Therapy, Postgraduate School of Molecular Medicine, Department of DermatologyErasmus Medical CenterRotterdamThe Netherlands

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