Departments of Radiology and Medical Physics, School of Medicine and Public Health, University of Wisconsin - Madison, Room 7137, 1111 Highland Ave, Madison, WI 53705-2275, USA.
Curr Pharm Biotechnol. 2013;14(8):733-42. doi: 10.2174/1389201014666131226113300.
Over the last several decades, development of various imaging techniques such as computed tomography, magnetic resonance imaging, and positron emission tomography greatly facilitated the early detection of cancer. Another important aspect that is closely related to the survival of cancer patients is complete tumor removal during surgical resection. The major obstacle in achieving this goal is to distinguish between tumor tissue and normal tissue during surgery. Currently, tumor margins are typically assessed by visual assessment and palpation of the tumor intraoperatively. However, the possibility of microinvasion to the surrounding tissues makes it difficult to determine an adequate tumor-free excision margin, often forcing the surgeons to perform wide excisions including the healthy tissue that may contain vital structures. It would be ideal to remove the tumor completely, with minimal safety margins, if surgeons could see precise tumor margins during the operation. Molecular imaging with optical techniques can visualize the tumors via fluorophore conjugated probes targeting tumor markers such as proteins and enzymes that are upregulated during malignant transformation. Intraoperative use of this technique may facilitate complete excision of the tumor and tumor micromasses located beyond the visual capacity of the naked eye, ultimately improving the clinical outcome and survival rates of cancer patients.
在过去的几十年中，各种成像技术的发展，如计算机断层扫描、磁共振成像和正电子发射断层扫描，极大地促进了癌症的早期发现。另一个与癌症患者生存密切相关的重要方面是在手术切除时完全切除肿瘤。实现这一目标的主要障碍是在手术过程中区分肿瘤组织和正常组织。目前，肿瘤边缘通常通过术中对肿瘤的视觉评估和触诊来评估。然而，肿瘤向周围组织微浸润的可能性使得确定足够的无肿瘤切除边缘变得困难，这往往迫使外科医生进行广泛的切除，包括可能包含重要结构的健康组织。如果外科医生在手术过程中能够看到精确的肿瘤边缘，那么理想情况下可以用最小的安全边缘完全切除肿瘤。光学技术的分子成像可以通过荧光团标记的探针来可视化肿瘤，这些探针针对在恶性转化过程中上调的肿瘤标志物，如蛋白质和酶。术中使用该技术可以促进肿瘤和肉眼看不见的肿瘤微转移的完全切除，最终提高癌症患者的临床结果和生存率。
