Image-guided cancer surgery: a narrative review on imaging modalities and emerging nanotechnology strategies

Abstract

Surgical resection is the cornerstone of solid tumour treatment. Current techniques for evaluating margin statuses, such as frozen section, imprint cytology, and intraoperative ultrasound, are helpful. However, an intraoperative assessment of tumour margins that is accurate and safe is clinically necessary. Positive surgical margins (PSM) have a well-documented negative effect on treatment outcomes and survival. As a result, surgical tumour imaging methods are now a practical method for reducing PSM rates and improving the efficiency of debulking surgery. Because of their unique characteristics, nanoparticles can function as contrast agents in image-guided surgery. While most image-guided surgical applications utilizing nanotechnology are now in the preclinical stage, some are beginning to reach the clinical phase. Here, we list the various imaging techniques used in image-guided surgery, such as optical imaging, ultrasound, computed tomography, magnetic resonance imaging, nuclear medicine imaging, and the most current developments in the potential of nanotechnology to detect surgical malignancies. In the coming years, we will see the evolution of nanoparticles tailored to specific tumour types and the introduction of surgical equipment to improve resection accuracy. Although the promise of nanotechnology for producing exogenous molecular contrast agents has been clearly demonstrated, much work remains to be done to put it into practice. Graphical Abstract

The Role of Staging Laparoscopy for Gastric Cancer Patients: Current Evidence and Future Perspectives

“…Furthermore, the development of image-guided surgical tools might integrate the AI application. In fact, while they have already been investigated to guide lymphadenectomy during resective surgery [98], the use of tools such as fluorescence could also help to detect microscopic peritoneal metastasis, similar to what has already been reported for ovarian cancer [99]. However, the evidence in the current literature is still anecdotal, and AI has not yet been employed in routine clinical practice on large datasets.…”

FGF19-Based Mini Probe Targeting FGFR4 for Diagnosis and Surgical Navigation of Hepatocellular Carcinoma

“…Medical imaging technology has significantly increased the precision of identifying tumor tissue during tumor resection surgery. − Surgeons can observe the distribution of near-infrared fluorescent (NIRF) probes in vivo and accurately remove tumors according to the tumor edges indicated by the probes. − NIRF probes are divided into active targeting probes and passive targeting probes. − Indocyanine green (ICG) is an approved passive targeting probe. Although ICG can be used in the diagnosis of liver cancer, it is difficult to diagnose small infiltrating lesions, especially liver metastasis. − An active targeting probe is developed on the premise of finding and identifying suitable tumor targets.…”

Deciphering the Role of H-Ferritin Nanocages in Improving Tumor-Targeted Delivery of Indocyanine Green: Combined Analysis of Murine Tissue Homogenates with UHPLC–MS/MS and Fluorescence

“…Indeed, many advantages stem from the implementation of NPs: (1) the combination or encapsulation of ICG into NPs results in the extension of its half-life; (2) through the functionalization with one or more targeting moieties specific for cancer cells, the selective accumulation of ICG at the tumor site can be achieved; (3) the nanoformulation of ICG may limit its aggregation and photodegradation as well as enhance its stability in aqueous solutions. Starting from this, the development of ICG-based NPs leads the way to several clinical outcomes including, photothermal therapy, photodynamic therapy, and imaging for cancer treatment. , According to literature, ICG has been loaded or conjugated to a plethora of NPs including lipid-based, polymeric-based, , and protein-based NPs . Very often these NPs have been further enriched by conjugation with other molecules such as monoclonal antibodies to maximize the specific tumor targeting and employed for cancer theranostic purposes …”