Progresses in Fluorescence Imaging Guidance for Bone and Soft Tissue Sarcoma Surgery

Abstract

R0 surgical resection is the preferred treatment for bone and soft tissue sarcoma. However, there is still a lack of precise technology that can visualize bone and soft tissue sarcoma during surgery to assist the surgeon in judging the tumor surgical boundary. Fluorescence imaging technology has been used in the diagnosis of cancer. It is a simple and essentially safe technique that takes no additional time during the operation. Intraoperative fluorescence imaging has potential application prospects in assisting the surgeons in judging the tumor boundary and improving the accuracy of surgical resection. This review mainly starts with clinical studies, animal experimentation, and newly designed probes of intraoperative fluorescence imaging of bone and soft tissue sarcoma, to appraise the application prospects of fluorescence imaging technology in bone and soft tissue sarcoma.

Near‐infrared (NIR) imaging with indocyanine green (ICG) may assist in intraoperative decision making and improving surgical margin in bone and soft tissue tumor surgery

“…Near‐infrared (NIR) fluorescence imaging is an emerging optical imaging technique that provides real‐time guidance for tumor characterization during surgery with greater sensitivity than direct visual inspection and palpation 9 . Indocyanine green (ICG) is the only US Food and Drug Administration‐approved fluorophore for intraoperative NIR imaging 10 . After intravenous injection, ICG binds to serum proteins and behaves as a macromolecule in circulation.…”

“…9 Indocyanine green (ICG) is the only US Food and Drug Administration-approved fluorophore for intraoperative NIR imaging. 10 After intravenous injection, ICG binds to serum proteins and behaves as a macromolecule in circulation. ICG can passively accumulate in tumor tissue via the enhanced permeability and retention (EPR), 11 and has been used to visualize tumors or sentinel lymph nodes in the breast, 12,13 gastric, 14 lung, 15 and several other types of cancer surgeries.…”