Department of Urology and Renal Transplantation, Martin-Luther University, Halle an der Saale, Germany.
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Eur Urol. 2014 May;65(5):947-64. doi: 10.1016/j.eururo.2013.07.033. Epub 2013 Aug 7.
Molecular imaging (MI) entails the visualisation, characterisation, and measurement of biologic processes at the molecular and cellular levels in humans and other living systems. Translating this technology to interventions in real-time enables interventional MI/image-guided surgery, for example, by providing better detection of tumours and their dimensions.
To summarise and critically analyse the available evidence on image-guided surgery for genitourinary (GU) oncologic diseases.
A comprehensive literature review was performed using PubMed and the Thomson Reuters Web of Science. In the free-text protocol, the following terms were applied: molecular imaging, genitourinary oncologic surgery, surgical navigation, image-guided surgery, and augmented reality. Review articles, editorials, commentaries, and letters to the editor were included if deemed to contain relevant information. We selected 79 articles according to the search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria and the IDEAL method.
MI techniques included optical imaging and fluorescent techniques, the augmented reality (AR) navigation system, magnetic resonance imaging spectroscopy, positron emission tomography, and single-photon emission computed tomography. Experimental studies on the AR navigation system were restricted to the detection and therapy of adrenal and renal malignancies and in the relatively infrequent cases of prostate cancer, whereas fluorescence techniques and optical imaging presented a wide application of intraoperative GU oncologic surgery. In most cases, image-guided surgery was shown to improve the surgical resectability of tumours.
Based on the evidence to date, image-guided surgery has promise in the near future for multiple GU malignancies. Further optimisation of targeted imaging agents, along with the integration of imaging modalities, is necessary to further enhance intraoperative GU oncologic surgery.
分子成像（MI）涉及在人体和其他生命系统中对分子和细胞水平的生物过程进行可视化、描述和测量。将这项技术转化为实时干预措施，使介入性 MI/图像引导手术成为可能，例如，通过更好地检测肿瘤及其大小。
总结和批判性分析有关泌尿生殖系统（GU）肿瘤疾病的图像引导手术的现有证据。
使用 PubMed 和 Thomson Reuters Web of Science 进行了全面的文献综述。在自由文本方案中，应用了以下术语：分子成像、泌尿生殖系统肿瘤手术、手术导航、图像引导手术和增强现实。如果认为包含相关信息，则包括综述文章、社论、评论和给编辑的信。根据基于系统评价和荟萃分析标准以及 IDEAL 方法的搜索策略，我们根据搜索策略选择了 79 篇文章。
MI 技术包括光学成像和荧光技术、增强现实（AR）导航系统、磁共振波谱成像、正电子发射断层扫描和单光子发射计算机断层扫描。AR 导航系统的实验研究仅限于肾上腺和肾恶性肿瘤的检测和治疗，以及相对罕见的前列腺癌病例，而荧光技术和光学成像则为术中 GU 肿瘤手术提供了广泛的应用。在大多数情况下，图像引导手术被证明可以提高肿瘤的手术可切除性。
根据目前的证据，图像引导手术在不久的将来有望用于多种 GU 恶性肿瘤。有必要进一步优化靶向成像剂，并整合成像方式，以进一步增强术中 GU 肿瘤手术。
