Clinical application of near infrared fluorescence imaging in solid cancers: Enhancing surgical accuracy by lighting up tumors

The current thesis investigates the use of novel optical imaging agents for the enhanced detection of solid cancer types. To date, it is challenging to differentiate between tumor tissue and adjacent healthy tissue, which is of the utmost importance during diagnosis and treatment phases of cancer patients. It is essential to precisely visualize which lesions are cancer, and subsequently determine the border of these lesions during surgery. Fluorescence imaging, where a fluorescent imaging agent lights up tumor cells, can assist in this clinical challenge. In the current thesis, fluorescence imaging has been performed during endoscopy procedures of the esophagus and colon, as well as during surgery procedures of a variety solid tumors. Here, it was found that fluorescence imaging can reliably assist in the detection of tumor tissue, and can help the clinician during the procedure in clinical decision-making. It was shown that fluorescence imaging was able to visualize tumor-positive resection margins and could detect additional tumor lesions, whereas this was missed using standard of care procedures. Based on the results described in this thesis, larger studies have been commenced to further investigate, and eventually implement, fluorescence imaging in the treatment of cancer patients.