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Intraoperative molecular imaging clinical trials: a review of 2020 conference proceedings.

  • Azari, Feredun1
  • Kennedy, Gregory1
  • Bernstein, Elizabeth1
  • Hadjipanayis, Constantinos2
  • Vahrmeijer, Alexander3
  • Smith, Barbara4
  • Rosenthal, Eben5
  • Sumer, Baran6
  • Tian, Jie7
  • Henderson, Eric8
  • Lee, Amy9
  • Nguyen, Quyen10
  • Gibbs, Summer11
  • Pogue, Brian12, 13
  • Orringer, Daniel14
  • Charalampaki, Cleopatra15
  • Martin, Linda16
  • Tanyi, Janos1
  • Lee, Major1
  • Lee, John Y1
  • And 1 more
  • 1 Perelman School of Medicine, Univ. of Pennsylvania, United States. , (United States)
  • 2 Icahn School of Medicine at Mount Sinai, United States. , (United States)
  • 3 Leiden Univ. Medical Ctr., Netherlands. , (Netherlands)
  • 4 Harvard Medical School, Harvard Univ., United States. , (United States)
  • 5 Stanford Univ. School of Medicine, United States. , (United States)
  • 6 The Univ. of Texas Southwestern Medical Ctr. at Dallas, United States. , (United States)
  • 7 Institute of Automation, Chinese Academy of Sciences, China. , (China)
  • 8 Dartmouth-Hitchcock Medical Ctr., United States. , (United States)
  • 9 Univ. of Washington, United States. , (United States)
  • 10 Univ. of California, San Diego, United States. , (United States)
  • 11 Oregon Health & Science Univ., United States. , (United States)
  • 12 Geisel School of Medicine, Dartmouth College, United States. , (United States)
  • 13 Thayer School of Engineering at Dartmouth, United States. , (United States)
  • 14 Univ. of Michigan, United States. , (United States)
  • 15 Medical Ctr. Cologne, Germany. , (Germany)
  • 16 Univ. of Virginia School of Medicine, United States. , (United States)
Published Article
Journal of Biomedical Optics
SPIE - International Society for Optical Engineering
Publication Date
May 01, 2021
DOI: 10.1117/1.JBO.26.5.050901
PMID: 34002555


Surgery is often paramount in the management of many solid organ malignancies because optimal resection is a major factor in disease-specific survival. Cancer surgery has multiple challenges including localizing small lesions, ensuring negative surgical margins around a tumor, adequately staging patients by discriminating positive lymph nodes, and identifying potential synchronous cancers. Intraoperative molecular imaging (IMI) is an emerging potential tool proposed to address these issues. IMI is the process of injecting patients with fluorescent-targeted contrast agents that highlight cancer cells prior to surgery. Over the last 5 to 7 years, enormous progress has been achieved in tracer development, near-infrared camera approvals, and clinical trials. Therefore, a second biennial conference was organized at the University of Pennsylvania to gather surgical oncologists, scientists, and experts to discuss new investigative findings in the field. Our review summarizes the discussions from the conference and highlights findings in various clinical and scientific trials. Recent advances in IMI were presented, and the importance of each clinical trial for surgical oncology was critically assessed. A major focus was to elaborate on the clinical endpoints that were being utilized in IMI trials to advance the respective surgical subspecialties. Principal investigators presenting at the Perelman School of Medicine Abramson Cancer Center's second clinical trials update on IMI were selected to discuss their clinical trials and endpoints. Multiple phase III, II, and I trials were discussed during the conference. Since the approval of 5-ALA for commercial use in neurosurgical malignancies, multiple tracers and devices have been developed to address common challenges faced by cancer surgeons across numerous specialties. Discussants also presented tracers that are being developed for delineation of normal anatomic structures that can serve as an adjunct during surgical procedures. IMI is increasingly being recognized as an improvement to standard oncologic surgical resections and will likely advance the art of cancer surgery in the coming years. The endpoints in each individual surgical subspecialty are varied depending on how IMI helps each specialty solve their clinical challenges.

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