Real-time fluorescence imaging in intraoperative decision making for cancer surgery

Lorraine J. Lauwerends; Pieter B.A.A. van Driel; Robert J. Baatenburg de Jong; José A.U. Hardillo; Senada Koljenovic; Gerwin Puppels; Laura Mezzanotte; Clemens W.G.M. Löwik; Eben L. Rosenthal; Alexander L. Vahrmeijer; Stijn Keereweer

doi:10.1016/S1470-2045(20)30600-8

Real-time fluorescence imaging in intraoperative decision making for cancer surgery

Lorraine J. Lauwerends, Pieter B.A.A. van Driel, Robert J. Baatenburg de Jong, José A.U. Hardillo, Senada Koljenovic, Gerwin Puppels, Laura Mezzanotte, Clemens W.G.M. Löwik, Eben L. Rosenthal, Alexander L. Vahrmeijer, Stijn Keereweer^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › Academic › peer-review

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Abstract

Fluorescence-guided surgery is an intraoperative optical imaging method that provides surgeons with real-time guidance for the delineation of tumours. Currently, in phase 1 and 2 clinical trials, evaluation of fluorescence-guided surgery is primarily focused on its diagnostic performance, although the corresponding outcome variables do not inform about the added clinical benefit of fluorescence-guided surgery and are challenging to assess objectively. Nonetheless, the effect of fluorescence-guided surgery on intraoperative decision making is the most objective outcome measurement to assess the clinical value of this imaging method. In this Review, we explore the study designs of existing trials of fluorescence-guided surgery that allow us to extract information on potential changes in intraoperative decision making, such as additional or more conservative resections. On the basis of this analysis, we offer recommendations on how to report changes in intraoperative decision making that result from fluorescence imaging, which is of utmost importance for the widespread clinical implementation of fluorescence-guided surgery.

Original language	English
Pages (from-to)	e186-e195
Journal	The Lancet Oncology
Volume	22
Issue number	5
Early online date	28 Apr 2021
DOIs	https://doi.org/10.1016/S1470-2045(20)30600-8
Publication status	Published - May 2021

Bibliographical note

Funding Information:
SKe is supported by the Bas Mulder Award from the Dutch Cancer Society (grant number 12175) and by the Daniel den Hoed Award from the Erasmus University Medical Center Foundation. This manuscript was edited for English language by Springer Nature Author Services, with funding from the European Commission under the H2020-MSCA-RISE Award (grant 872860).

Publisher Copyright:
© 2021 Elsevier Ltd

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Cite this

Lauwerends, L. J., van Driel, P. B. A. A., Baatenburg de Jong, R. J., Hardillo, J. A. U., Koljenovic, S., Puppels, G., Mezzanotte, L., Löwik, C. W. G. M., Rosenthal, E. L., Vahrmeijer, A. L., & Keereweer, S. (2021). Real-time fluorescence imaging in intraoperative decision making for cancer surgery. The Lancet Oncology, 22(5), e186-e195. https://doi.org/10.1016/S1470-2045(20)30600-8

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title = "Real-time fluorescence imaging in intraoperative decision making for cancer surgery",

abstract = "Fluorescence-guided surgery is an intraoperative optical imaging method that provides surgeons with real-time guidance for the delineation of tumours. Currently, in phase 1 and 2 clinical trials, evaluation of fluorescence-guided surgery is primarily focused on its diagnostic performance, although the corresponding outcome variables do not inform about the added clinical benefit of fluorescence-guided surgery and are challenging to assess objectively. Nonetheless, the effect of fluorescence-guided surgery on intraoperative decision making is the most objective outcome measurement to assess the clinical value of this imaging method. In this Review, we explore the study designs of existing trials of fluorescence-guided surgery that allow us to extract information on potential changes in intraoperative decision making, such as additional or more conservative resections. On the basis of this analysis, we offer recommendations on how to report changes in intraoperative decision making that result from fluorescence imaging, which is of utmost importance for the widespread clinical implementation of fluorescence-guided surgery.",

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note = "Funding Information: SKe is supported by the Bas Mulder Award from the Dutch Cancer Society (grant number 12175) and by the Daniel den Hoed Award from the Erasmus University Medical Center Foundation. This manuscript was edited for English language by Springer Nature Author Services, with funding from the European Commission under the H2020-MSCA-RISE Award (grant 872860). Publisher Copyright: {\textcopyright} 2021 Elsevier Ltd",

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AU - Rosenthal, Eben L.

AU - Vahrmeijer, Alexander L.

AU - Keereweer, Stijn

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N2 - Fluorescence-guided surgery is an intraoperative optical imaging method that provides surgeons with real-time guidance for the delineation of tumours. Currently, in phase 1 and 2 clinical trials, evaluation of fluorescence-guided surgery is primarily focused on its diagnostic performance, although the corresponding outcome variables do not inform about the added clinical benefit of fluorescence-guided surgery and are challenging to assess objectively. Nonetheless, the effect of fluorescence-guided surgery on intraoperative decision making is the most objective outcome measurement to assess the clinical value of this imaging method. In this Review, we explore the study designs of existing trials of fluorescence-guided surgery that allow us to extract information on potential changes in intraoperative decision making, such as additional or more conservative resections. On the basis of this analysis, we offer recommendations on how to report changes in intraoperative decision making that result from fluorescence imaging, which is of utmost importance for the widespread clinical implementation of fluorescence-guided surgery.

AB - Fluorescence-guided surgery is an intraoperative optical imaging method that provides surgeons with real-time guidance for the delineation of tumours. Currently, in phase 1 and 2 clinical trials, evaluation of fluorescence-guided surgery is primarily focused on its diagnostic performance, although the corresponding outcome variables do not inform about the added clinical benefit of fluorescence-guided surgery and are challenging to assess objectively. Nonetheless, the effect of fluorescence-guided surgery on intraoperative decision making is the most objective outcome measurement to assess the clinical value of this imaging method. In this Review, we explore the study designs of existing trials of fluorescence-guided surgery that allow us to extract information on potential changes in intraoperative decision making, such as additional or more conservative resections. On the basis of this analysis, we offer recommendations on how to report changes in intraoperative decision making that result from fluorescence imaging, which is of utmost importance for the widespread clinical implementation of fluorescence-guided surgery.

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Real-time fluorescence imaging in intraoperative decision making for cancer surgery

Abstract

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