Molecular image-guided surgery has the potential for translating the tools of molecular pathology to real-time guidance in surgery. As a whole, there are incredibly positive indicators of growth, including the first US FDA clearance of an enzyme-biosynthetic-activated probe for surgery guidance, and a growing number of companies producing agents and imaging systems. The strengths and opportunities must be continued but are hampered by important weaknesses and threats within the field. The ultimate potential may require multiple probes, as are used in molecular pathology, and a combination with ultra-high resolution imaging and image recognition systems which capture the data at a finer granularity than is possible by the surgeon. size-fits-all’ concept, similar to metabolic aberrations as exploited in FDG-PET (i.e. Warburg effect) or tumor acidity. Finally, methods to approach the problem of production cost minimization and regulatory approvals in a manner consistent with the potential revenue of the field will be important. In this area, some solid steps have been demonstrated in the use of fluorescent labeling commercial antibodies and separately in microdosing studies with small molecules.

Date Published: 7 March 2019
PDF
Proc. SPIE 10862, Molecular-Guided Surgery: Molecules, Devices, and Applications V, 1086211 (7 March 2019); doi: 10.1117/12.2511122

Published in SPIE Proceedings Vol. 10862:
Molecular-Guided Surgery: Molecules, Devices, and Applications V
Brian W. Pogue; Sylvain Gioux, Editor(s)