Image‐guided tumor surgery: The emerging role of nanotechnology

Abstract

Surgical resection is a mainstay treatment for solid tumors. Yet, methods to distinguish malignant from healthy tissue are primarily limited to tactile and visual cues as well as the surgeon's experience. As a result, there is a possibility that a positive surgical margin (PSM) or the presence of residual tumor left behind after resection may occur. It is well‐documented that PSMs can negatively impact treatment outcomes and survival, as well as pose an economic burden. Therefore, surgical tumor imaging techniques have emerged as a promising method to decrease PSM rates. Nanoparticles (NPs) have unique characteristics to serve as optical contrast agents during image‐guided surgery (IGS). Recently, there has been tremendous growth in the volume and types of NPs used for IGS, including clinical trials. Herein, we describe the most recent contributions of nanotechnology for surgical tumor identification. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease Implantable Materials and Surgical Technologies > Nanoscale Tools and Techniques in Surgery Diagnostic Tools > in vivo Nanodiagnostics and Imaging

CKAP4 Antibody-Conjugated Si Quantum Dot Micelles for Targeted Imaging of Lung Cancer

“…At present, various fluorescent nanomaterials have been designed and synthesized as optical contrast agents for surgical navigation [ 3 , 4 ]. In 2020, On et al prepared fluorophore [indocyanine green (ICG) or cyanine 5.5 (Cy5.5)]-conjugated glycol chitosan nanoparticles (CNPs) as a fluorescent contrast agent in lung cancer surgery navigation [ 18 ].…”

“…Surgical resection is the primary treatment for solid tumors. However, the methods of differentiating malignant tissue from healthy tissue are mainly limited to tactile and visual cues and the surgeon’s experience [ 3 ].…”

“…With the help of a fluorescence contrast agent and fluorescence-imaging system, surgeons can use real-time image guidance to resect the primary tumors and identify residual tumors in the operating cavity. Compared with traditional biomedical imaging methods, fluorescence-imaging system offers several advantages, such as the absence of ionizing radiation and high spatial resolution [ 3 , 5 , 6 ].…”

Therapy-Induced Modulation of the Tumor Microenvironment: New Opportunities for Cancer Therapies

“…The most clinically advanced nanoprobe is LUM015 (a pegylated cathepsin-activatable probe) which is undergoing eight clinical trials, including a pivotal phase 3 study (60). The phase 3 trial is a multicenter study with the primary objective of assessing the ability of LUM015 and LUM fluorescence-guided surgery system to detect residual tumors in 250 breast cancer patients undergoing lumpectomy (NCT03686215).…”

In situ tissue pathology from spatially encoded mass spectrometry classifiers visualized in real time through augmented reality

“…This assumption needs further independent validation especially in cases where presence of cancer could result in swelling of the brain and edema where metabolic heterogeneity in morphometrically identical tissue regions may be resulted. Lastly, the performance of our proposed label-free spatially encoded mass spectrometry pathology platform should be compared to competing methodologies, such as other image based optical or uorescence-based methods, 46 and eventually scored against surgical outcomes to evaluate reduced neurologic morbidity, low local failure rate (recurrence) and/or improved outcomes. It will be of special interest to evaluate the method in its true 3D sampling capacity as opposed to augmented reality display of its 2D projections as is done here in this rst step.…”