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Optical image-guided surgery for radical tumor resection

Using non-invasive imaging technologies like CT, MRI and PET, cancer can be detected much earlier and the tumor tissue can subsequently be removed by surgery. However, it is of great importance that during operation the tumor is completely (radically) removed with enough tumor-free margin. Because during surgery it is difficult to distinguish between tumor tissue and normal tissue, and it is also difficult to determine an adequate tumor-free margin, non-radical resections remain a serious clinical problem. It is also a problem to identify lymph node metastases during surgery. However, if during surgery one is able to identify tumor margins and local (lymph node) metastases using imaging and subsequently to radically remove them, the life expectancy of cancer patients will greatly improve. A highly promising new development in surgical oncology is image-guided tumor resection using optical imaging. By injecting a tumor specific near infrared fluorescent (NIRF) probe, the extent of the primary tumor as well as the sites of disseminated disease can be imaged using a dedicated NIRF camera system. The Artemis platform is perfectly suited for this purpose and offers the advantage of real-time imaging of multiple wavelengths, enabling to correct for photon-tissue interaction, spectral un-mixing of auto fluorescence signals and the use of multiple probes at the same time......

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