TY - JOUR
T1 - The complementary value of intraoperative fluorescence imaging and Raman spectroscopy for cancer surgery
T2 - combining the incompatibles
AU - Lauwerends, L. J.
AU - Abbasi, H.
AU - Bakker Schut, T. C.
AU - Van Driel, P. B.A.A.
AU - Hardillo, J. A.U.
AU - Santos, I. P.
AU - Barroso, E. M.
AU - Koljenović, S.
AU - Vahrmeijer, A. L.
AU - Baatenburg de Jong, R. J.
AU - Puppels, G. J.
AU - Keereweer, S.
N1 - Funding Information:
This work was supported by the Dutch Cancer Society KWF [Research Grant: 12175] and the Daniel den Hoed Fonds.
Publisher Copyright:
© 2022, The Author(s).
PY - 2022/6
Y1 - 2022/6
N2 - A clear margin is an important prognostic factor for most solid tumours treated by surgery. Intraoperative fluorescence imaging using exogenous tumour-specific fluorescent agents has shown particular benefit in improving complete resection of tumour tissue. However, signal processing for fluorescence imaging is complex, and fluorescence signal intensity does not always perfectly correlate with tumour location. Raman spectroscopy has the capacity to accurately differentiate between malignant and healthy tissue based on their molecular composition. In Raman spectroscopy, specificity is uniquely high, but signal intensity is weak and Raman measurements are mainly performed in a point-wise manner on microscopic tissue volumes, making whole-field assessment temporally unfeasible. In this review, we describe the state-of-the-art of both optical techniques, paying special attention to the combined intraoperative application of fluorescence imaging and Raman spectroscopy in current clinical research. We demonstrate how these techniques are complementary and address the technical challenges that have traditionally led them to be considered mutually exclusive for clinical implementation. Finally, we present a novel strategy that exploits the optimal characteristics of both modalities to facilitate resection with clear surgical margins.
AB - A clear margin is an important prognostic factor for most solid tumours treated by surgery. Intraoperative fluorescence imaging using exogenous tumour-specific fluorescent agents has shown particular benefit in improving complete resection of tumour tissue. However, signal processing for fluorescence imaging is complex, and fluorescence signal intensity does not always perfectly correlate with tumour location. Raman spectroscopy has the capacity to accurately differentiate between malignant and healthy tissue based on their molecular composition. In Raman spectroscopy, specificity is uniquely high, but signal intensity is weak and Raman measurements are mainly performed in a point-wise manner on microscopic tissue volumes, making whole-field assessment temporally unfeasible. In this review, we describe the state-of-the-art of both optical techniques, paying special attention to the combined intraoperative application of fluorescence imaging and Raman spectroscopy in current clinical research. We demonstrate how these techniques are complementary and address the technical challenges that have traditionally led them to be considered mutually exclusive for clinical implementation. Finally, we present a novel strategy that exploits the optimal characteristics of both modalities to facilitate resection with clear surgical margins.
UR - http://www.scopus.com/inward/record.url?scp=85123909815&partnerID=8YFLogxK
U2 - 10.1007/s00259-022-05705-z
DO - 10.1007/s00259-022-05705-z
M3 - Review article
C2 - 35102436
AN - SCOPUS:85123909815
SN - 1619-7070
VL - 49
SP - 2364
EP - 2376
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 7
ER -