Real-time fluorescence imaging in intraoperative decision making for cancer surgery. 2021

Lorraine J Lauwerends, and Pieter B A A van Driel, and Robert J Baatenburg de Jong, and José A U Hardillo, and Senada Koljenovic, and Gerwin Puppels, and Laura Mezzanotte, and Clemens W G M Löwik, and Eben L Rosenthal, and Alexander L Vahrmeijer, and Stijn Keereweer
Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands.

Fluorescence-guided surgery is an intraoperative optical imaging method that provides surgeons with real-time guidance for the delineation of tumours. Currently, in phase 1 and 2 clinical trials, evaluation of fluorescence-guided surgery is primarily focused on its diagnostic performance, although the corresponding outcome variables do not inform about the added clinical benefit of fluorescence-guided surgery and are challenging to assess objectively. Nonetheless, the effect of fluorescence-guided surgery on intraoperative decision making is the most objective outcome measurement to assess the clinical value of this imaging method. In this Review, we explore the study designs of existing trials of fluorescence-guided surgery that allow us to extract information on potential changes in intraoperative decision making, such as additional or more conservative resections. On the basis of this analysis, we offer recommendations on how to report changes in intraoperative decision making that result from fluorescence imaging, which is of utmost importance for the widespread clinical implementation of fluorescence-guided surgery.

UI MeSH Term Description Entries
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D009369 Neoplasms New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms. Benign Neoplasm,Cancer,Malignant Neoplasm,Tumor,Tumors,Benign Neoplasms,Malignancy,Malignant Neoplasms,Neoplasia,Neoplasm,Neoplasms, Benign,Cancers,Malignancies,Neoplasias,Neoplasm, Benign,Neoplasm, Malignant,Neoplasms, Malignant
D012107 Research Design A plan for collecting and utilizing data so that desired information can be obtained with sufficient precision or so that an hypothesis can be tested properly. Experimental Design,Data Adjustment,Data Reporting,Design, Experimental,Designs, Experimental,Error Sources,Experimental Designs,Matched Groups,Methodology, Research,Problem Formulation,Research Methodology,Research Proposal,Research Strategy,Research Technics,Research Techniques,Scoring Methods,Adjustment, Data,Adjustments, Data,Data Adjustments,Design, Research,Designs, Research,Error Source,Formulation, Problem,Formulations, Problem,Group, Matched,Groups, Matched,Matched Group,Method, Scoring,Methods, Scoring,Problem Formulations,Proposal, Research,Proposals, Research,Reporting, Data,Research Designs,Research Proposals,Research Strategies,Research Technic,Research Technique,Scoring Method,Source, Error,Sources, Error,Strategies, Research,Strategy, Research,Technic, Research,Technics, Research,Technique, Research,Techniques, Research
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D003657 Decision Making The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D005453 Fluorescence The property of emitting radiation while being irradiated. The radiation emitted is usually of longer wavelength than that incident or absorbed, e.g., a substance can be irradiated with invisible radiation and emit visible light. X-ray fluorescence is used in diagnosis.
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D061848 Optical Imaging The use of light interaction (scattering, absorption, and fluorescence) with biological tissue to obtain morphologically based information. It includes measuring inherent tissue optical properties such as scattering, absorption, and autofluorescence; or optical properties of exogenous targeted fluorescent molecular probes such as those used in optical MOLECULAR IMAGING, or nontargeted optical CONTRAST AGENTS. Fundus Autofluorescence Imaging,Autofluorescence Imaging,Fluorescence Imaging,Autofluorescence Imaging, Fundus,Fundus Autofluorescence Imagings,Imaging, Autofluorescence,Imaging, Fluorescence,Imaging, Fundus Autofluorescence,Imaging, Optical
D025321 Surgery, Computer-Assisted Surgical procedures conducted with the aid of computers. Used in various types of surgery for implant placement and instrument guidance. Image-guided surgery interactively combines prior CT scans or MRI images with real-time video. Computer-Assisted Surgery,Image-Guided Surgery,Surgery, Image-Guided,Surgical Navigation,Computer-Aided Surgery,Computer Aided Surgery,Computer Assisted Surgery,Computer-Aided Surgeries,Computer-Assisted Surgeries,Image Guided Surgery,Image-Guided Surgeries,Navigation, Surgical,Surgeries, Computer-Aided,Surgeries, Computer-Assisted,Surgeries, Image-Guided,Surgery, Computer Assisted,Surgery, Computer-Aided,Surgery, Image Guided

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