Emerging Intraoperative Imaging Modalities to Improve Surgical Precision

Israt S. Alam, Idan Steinberg, Ophir Vermesh, Nynke S. van den Berg, Eben L. Rosenthal, Gooitzen M. van Dam, Vasilis Ntziachristos, Sanjiv S. Gambhir, Sophie Hernot, Stephan Rogalla*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

30 Citations (Scopus)

Abstract

Intraoperative imaging (IOI) is performed to guide delineation and localization of regions of surgical interest. While oncological surgical planning predominantly utilizes x-ray computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US), intraoperative guidance mainly remains on surgeon interpretation and pathology for confirmation. Over the past decades however, intraoperative guidance has evolved significantly with the emergence of several novel imaging technologies, including fluorescence-, Raman, photoacoustic-, and radio-guided approaches. These modalities have demonstrated the potential to further optimize precision in surgical resection and improve clinical outcomes for patients. Not only can these technologies enhance our understanding of the disease, they can also yield large imaging datasets intraoperatively that can be analyzed by deep learning approaches for more rapid and accurate pathological diagnosis. Unfortunately, many of these novel technologies are still under preclinical or early clinical evaluation. Organizations like the Intra-Operative Imaging Study Group of the European Society for Molecular Imaging (ESMI) support interdisciplinary interactions with the aim to improve technical capabilities in the field, an approach that can succeed only if scientists, engineers, and physicians work closely together with industry and regulatory bodies to resolve roadblocks to clinical translation. In this review, we provide an overview of a variety of novel IOI technologies, discuss their challenges, and present future perspectives on the enormous potential of IOI for oncological surgical navigation.

Original languageEnglish
Pages (from-to)705-715
Number of pages11
JournalMolecular Imaging and Biology
Volume20
Issue number5
DOIs
Publication statusPublished - Oct-2018

Keywords

  • Intraoperative imaging
  • Surgical navigation
  • Image-guided surgery
  • Fluorescence imaging
  • Raman spectrometry
  • Photoacoustic imaging
  • Optoacoustic imaging
  • Thermoacoustic imaging
  • Radio-guided surgery
  • Deep learning
  • CONVOLUTION NEURAL-NETWORK
  • MULTISPECTRAL OPTOACOUSTIC TOMOGRAPHY
  • FLUORESCENCE-GUIDED SURGERY
  • LUNG NODULE DETECTION
  • LYMPH-NODE BIOPSY
  • CANCER-DETECTION
  • NECK-CANCER
  • CLUSTERED MICROCALCIFICATIONS
  • COMPUTERIZED DETECTION
  • DIGITAL MAMMOGRAMS

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