Intraoperative molecular imaging: 3rd biennial clinical trials update

Abstract

. Significance This third biennial intraoperative molecular imaging (IMI) conference shows how optical contrast agents have been applied to develop clinically significant endpoints that improve precision cancer surgery. Aim National and international experts on IMI presented ongoing clinical trials in cancer surgery and preclinical work. Previously known dyes (with broader applications), new dyes, novel nonfluorescence-based imaging techniques, pediatric dyes, and normal tissue dyes were discussed. Approach Principal investigators presenting at the Perelman School of Medicine Abramson Cancer Center’s third clinical trials update on IMI were selected to discuss their clinical trials and endpoints. Results Dyes that are FDA-approved or currently under clinical investigation in phase 1, 2, and 3 trials were discussed. Sections on how to move benchwork research to the bedside were also included. There was also a dedicated section for pediatric dyes and nonfluorescence-based dyes that have been newly developed. Conclusions IMI is a valuable adjunct in precision cancer surgery and has broad applications in multiple subspecialties. It has been reliably used to alter the surgical course of patients and in clinical decision making. There remain gaps in the utilization of IMI in certain subspecialties and potential for developing newer and improved dyes and imaging techniques.

Fluorescent Probes for Imaging in Humans: Where Are We Now?

“…There has also been increasing research on fluorescent structures to image vital structures (e.g., nerves). 84,85 These fluorophores hold potential not only to improve the outcomes of tumor resection but also to facilitate the visualization of anatomical structures in challenging surgeries.…”

“…This includes dyes in the NIR window and structural modifications of existing scaffolds toward longer absorbance and emission wavelengths. There has also been increasing research on fluorescent structures to image vital structures (e.g., nerves). , These fluorophores hold potential not only to improve the outcomes of tumor resection but also to facilitate the visualization of anatomical structures in challenging surgeries.…”

Deep learning architectures for spatial-frequency 3D fluorescence in oral cancer surgery models

“…5 Fluorescence-guided surgery can provide improved delineation of target anatomy, leading to better patient outcomes. 6 This technique relies on fluorophore accumulation in the tumor to illustrate the boundary between tumor and healthy tissue. 7 When fluorophore-specific wavelengths of light are absorbed, the fluorophore becomes excited and re-emits light at a longer wavelength.…”

Fluorescence-guided surgical system using holographic display: from phantom studies to canine patients

“…Since 2021, pafolacianine has been approved globally for imaging ovarian and lung tumors that overexpress folate receptors 13 – 15 Many other tumor-targeted probes are in phase three clinical trials or have completed them, and commercialization is imminent 9 , 16 , 17 …”

“…[13][14][15] Many other tumor-targeted probes are in phase three clinical trials or have completed them, and commercialization is imminent. 9,16,17 Intraoperative imaging and illumination devices have greatly benefited from advancements in cellphone camera technology and photonics materials. 18 Miniature imaging sensors have enabled high-resolution, real-time imaging in both visible and NIR spectrums for both open and minimally invasive surgeries.…”