RT Journal Article
SR Electronic
T1 Precision Surgery Guided by Intraoperative Molecular Imaging
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1620
OP 1627
DO 10.2967/jnumed.121.263409
VO 63
IS 11
A1 Feredun Azari
A1 Kevin Zhang
A1 Gregory T. Kennedy
A1 Ashley Chang
A1 Bilal Nadeem
A1 Edward J. Delikatny
A1 Sunil Singhal
YR 2022
UL http://jnm.snmjournals.org/content/63/11/1620.abstract
AB Intraoperative molecular imaging (IMI) has recently emerged as an important tool in the armamentarium of surgical oncologists. IMI allows real-time assessment of oncologic resection quality, margin assessment, and occult disease detection during real-time surgery. Numerous tracers have now been developed for use in IMI-guided tissue sampling. Fluorochromes localize to the tumor by taking advantage of their disorganized capillary milieu, overexpressed receptors, or upregulated enzymes. Although fluorescent tracers can suffer from issues of autofluorescence and lack of depth penetration, these challenges are being addressed through hybrid radioactive/fluorescent tracers and new tracers that fluoresce in the near-infrared (NIR-II [wavelength > 1,000 nm]) range. IMI is already being used to treat numerous cancers, with demonstrated improvement in cancer recurrence and patient outcomes without incurring significant burden on either clinicians or patients. In this comprehensive review, we discuss history, mechanism, current oncologic applications, and future directions of IMI-guided optical biopsy.