• The lancet oncology · May 2021

    Review

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

    • Lorraine J Lauwerends, Pieter B A A van Driel, Robert J Baatenburg de Jong, José A U Hardillo, Senada Koljenovic, Gerwin Puppels, Laura Mezzanotte, LöwikClemens W G MCWGMDepartment of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Oncology, Cent, Eben L Rosenthal, 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.
    • Lancet Oncol. 2021 May 1; 22 (5): e186-e195.

    AbstractFluorescence-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.Copyright © 2021 Elsevier Ltd. All rights reserved.

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