Innovations in Intraoperative Tumor Visualization

Visgauss, Julia D.; Eward, William C.; Brigman, Brian E.

doi:10.1016/j.ocl.2015.08.023

Cited by 11 publications

(47 citation statements)

References 56 publications

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“…Previous reviews on technologies for surgical margin assessment in other tumour types predicted, in 2014, an increase in the clinical use of these technologies [30][31][32][33]. Currently, only NeuroSAFE is used for PCa in daily practice in specific institutions, and one could ask why these technologies are not incorporated on a more frequent basis.…”

Section: Discussionmentioning

confidence: 99%

“…PSMA is often overexpressed by PCa cells, and the ligand can be bound to an infrared fluorescent dye or Cy5 dye. This dye has absorption and emission wavelengths in the NIR and far red ranges, enabling fluorescence imaging using a fluorophore [30,39,40]. PSMA can also be coupled to 68 Gallium, enabling Cerenkov luminescence imaging during surgery using positron emitting properties of 68 Gallium.…”

Section: Alternative and Future Technologiesmentioning

confidence: 99%

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State-of-the-art Intraoperative Imaging Technologies for Prostate Margin Assessment: A Systematic Review

Heuvel

Veen

Huizing

et al. 2021

European Urology Focus

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Context: The main challenge in radical prostatectomy is complete excision of malignant tissue, while preserving continence and erectile function. Positive surgical margins (PSMs) occur in up to 38% of cases, are associated with tumour recurrences, and may result in debilitating additional therapies. Despite surgical developments for prostate cancer (PCa), no technology is yet implemented to assess surgical margins of the entire prostatic surface intraoperatively. Objective: The aim of this systematic review is to provide an overview of novel imaging methods developed for intraoperative margin assessment in PCa surgery, which are compared with standard postoperative histopathology. Evidence acquisition: A literature search of the last 10 yr was conducted in the Scopus, PubMed, and Embase (Ovid) databases. Eligible articles had to report the PSM rate according to their intraoperative margin assessment technology in comparison with standard histopathology. Evidence synthesis: The search resulted in 616 original articles, of which 11 were included for full-text review. The main technical developments in PCa margin assessment included optical coherence tomography, photodynamic diagnosis with 5-aminolevulinic acid, spectroscopy, and enhanced microscopy. These techniques are described and their main advantages, limitations, and applications in the clinical setting are discussed. Conclusions: Several imaging methods are suggested in literature for the detection of positive margins during PCa surgery. Despite promising qualifications of the mentioned technologies, many struggle to find implementation in the clinic. Surgical conditions hampering the signal, long imaging times, and comparison with histopathology are mutual challenges. The next step towards reduction of PSMs in PCa surgery includes evaluation of these technologies in large clinical trials. Patient summary: In this review, new technologies are reported that can assist the surgeon by detecting insufficient removal of all tumorous tissue during surgery, instead of the standard postoperative histopathological assessment. Currently, it is not clear whether these technologies improve the patient outcome directly; however, the review shows potential future implementations.

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Section: Discussionmentioning

confidence: 99%

Section: Alternative and Future Technologiesmentioning

confidence: 99%

State-of-the-art Intraoperative Imaging Technologies for Prostate Margin Assessment: A Systematic Review

Heuvel

Veen

Huizing

et al. 2021

European Urology Focus

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“…First, a tissue surface is illuminated by light of a single wavelength that is either reflected, back-scattered, or induces autofluorescence. Emitted autofluoresced light is detected by a camera and displayed onto a monitor for interpretation within the visible light spectrum [ 13 ]. Tissue fluorescence is determined by its molecular composition, so benign and malignant tissues can be differentiated based on their color and quantity of autofluorescence [ 14 ].…”

Section: Upcoming Imaging Conceptsmentioning

confidence: 99%

“…Bronchoscopes with autofluorescent capabilities are currently being evaluated in cancer and precancerous lesion detection. The sensitivity of autofluorescence seems to be greater than that of white light bronchoscopy, but results regarding specificity have been variable [ 13 ]. When discriminating between adenomas from hyperplastic colonic polyps, autofluorescence has shown high sensitivity and specificity at 89 and 81%, respectively.…”

Section: Upcoming Imaging Conceptsmentioning

confidence: 99%

“…Advantages of autofluorescence technology include real-time image acquisition, intra-surgical tumor assessment, lack of need for exogenous fluorophores, wide field-of-view, and ability to quantify fluorescence for objective diagnostic information. Limitations of this technology include its shallow depth-of-field, low specificity, high false positive rate, high cost, increased exam time, interference from bodily fluids within surgical field, and changes in tissue autofluorescence secondary to treatment [ 13 – 15 ].…”

Section: Upcoming Imaging Conceptsmentioning

confidence: 99%

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Upcoming imaging concepts and their impact on treatment planning and treatment response in radiation oncology

et al. 2018

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For 2018, the American Cancer Society estimated that there would be approximately 1.7 million new diagnoses of cancer and about 609,640 cancer-related deaths in the United States. By 2030 these numbers are anticipated to exceed a staggering 21 million annual diagnoses and 13 million cancer-related deaths. The three primary therapeutic modalities for cancer treatments are surgery, chemotherapy, and radiation therapy. Individually or in combination, these treatment modalities have provided and continue to provide curative and palliative care to the myriad victims of cancer.Today, CT-based treatment planning is the primary means through which conventional photon radiation therapy is planned. Although CT remains the primary treatment planning modality, the field of radiation oncology is moving beyond the sole use of CT scans to define treatment targets and organs at risk. Complementary tissue scans, such as magnetic resonance imaging (MRI) and positron electron emission (PET) scans, have all improved a physician’s ability to more specifically identify target tissues, and in some cases, international guidelines have even been issued. Moreover, efforts to combine PET and MR to define solid tumors for radiotherapy planning and treatment evaluation are also gaining traction.Keeping these advances in mind, we present brief overviews of other up-and-coming key imaging concepts that appear promising for initial treatment target definition or treatment response from radiation therapy.

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Optical spectroscopy and imaging in surgical management of cancer patients

Wilson

2022

Transl Biophotonics

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Surgery is a pillar of cancer management, the general goal being complete removal of solid tumor tissue with minimal damage to normal tissue structure and function. Optical imaging and spectroscopy may contribute to this at several points in the procedural chain, including preoperative tumor localization and staging by biopsy, intra/perioperative identification and localization of tumor margins, detection of residual tumor tissue and tumor‐involved lymph nodes as well as critical normal tissue structures, and assessment of the viability of reconstructed tissues following tumor resection. The numerous optical modalities that can be implemented clinically are discussed, a few of which are already in clinical practice and many more are in clinical trials. These modalities utilize different light‐tissue interactions and technical approaches. The resulting biological information obtained, the current or potential clinical impact, limitations and potential future developments and roles are considered. This article is intended to inform the biophotonics community of the clinical needs and scientific/technical challenges and opportunities in photonics‐enabled surgical guidance and to guide potential surgical users on the potential advantages and limitations in this rapidly evolving landscape.

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Innovations in Intraoperative Tumor Visualization

Cited by 11 publications

References 56 publications

State-of-the-art Intraoperative Imaging Technologies for Prostate Margin Assessment: A Systematic Review

State-of-the-art Intraoperative Imaging Technologies for Prostate Margin Assessment: A Systematic Review

Upcoming imaging concepts and their impact on treatment planning and treatment response in radiation oncology

Optical spectroscopy and imaging in surgical management of cancer patients

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