Bugby S L, Lees J E, Perkins A C
Space Research Centre, Michael Atiyah Building, University of Leicester, Leicester, LE1 7RH UK.
Radiological Sciences, Division of Clinical Neuroscience, School of Medical, University of Nottingham, Nottingham, NG7 2UH UK.
Clin Transl Imaging. 2017;5(4):323-341. doi: 10.1007/s40336-017-0235-x. Epub 2017 Jun 27.
This review aims to summarise the hybrid modality radioguidance techniques currently in clinical use and development, and to discuss possible future avenues of research. Due to the novelty of these approaches, evidence of their clinical relevance does not yet exist. The purpose of this review is to inform nuclear medicine practitioners of current cutting edge research in radioguided surgery which may enter standard clinical practice within the next 5-10 years. Hybrid imaging is of growing importance to nuclear medicine diagnostics, but it is only with recent advances in technology that hybrid modalities are being investigated for use during radioguided surgery. These modalities aim to overcome some of the difficulties of surgical imaging while maintaining many benefits, or providing entirely new information unavailable to surgeons with traditional radioguidance.
A literature review was carried out using online reference databases (Scopus, PubMed). Review articles obtained using this technique were citation mined to obtain further references.
In total, 2367 papers were returned, with 425 suitable for further assessment. 60 papers directly related to hybrid intraoperative imaging in radioguided surgery are reported on. Of these papers, 25 described the clinical use of hybrid imaging, 22 described the development of new hybrid probes and tracers, and 13 described the development of hybrid technologies for future clinical use. Hybrid gamma-NIR fluorescence was found to be the most common clinical technique, with 35 papers associated with these modalities. Other hybrid combinations include gamma-bright field imaging, gamma-ultrasound imaging, gamma-β imaging and β-OCT imaging. The combination of preoperative and intraoperative images is also discussed.
Hybrid imaging offers new possibilities for assisting clinicians and surgeons in localising the site of uptake in procedures such as in sentinel node detection.
本综述旨在总结目前临床应用和研发中的混合模式放射引导技术，并探讨未来可能的研究方向。由于这些方法较为新颖，尚无其临床相关性的证据。本综述的目的是让核医学从业者了解放射引导手术方面当前的前沿研究，这些研究可能在未来5至10年内进入标准临床实践。混合成像对核医学诊断的重要性日益增加，但直到最近技术取得进展，才开始研究将混合模式用于放射引导手术。这些模式旨在克服手术成像的一些困难，同时保留诸多益处，或提供传统放射引导无法为外科医生提供的全新信息。
使用在线参考数据库（Scopus、PubMed）进行文献综述。通过该技术获取的综述文章进行引文挖掘以获取更多参考文献。
共检索到2367篇论文，其中425篇适合进一步评估。报告了60篇与放射引导手术中混合术中成像直接相关的论文。在这些论文中，25篇描述了混合成像的临床应用，22篇描述了新型混合探头和示踪剂的研发，13篇描述了用于未来临床应用的混合技术的研发。发现混合伽马-近红外荧光是最常见的临床技术，有35篇论文涉及这些模式。其他混合组合包括伽马-明场成像、伽马-超声成像、伽马-β成像和β-光学相干断层扫描成像。还讨论了术前和术中图像的结合。
混合成像为协助临床医生和外科医生在诸如前哨淋巴结检测等程序中定位摄取部位提供了新的可能性。
