title: Current perspectives in the use of molecular imaging to target surgical treatments for genitourinary cancers.
abstract: BACKGROUND
  Molecular imaging (MI) entails the visualisation, characterisation, and measurement of biologic processes at the molecular and cellular levels in humans and other living systems. Translating this technology to interventions in real-time enables interventional MI/image-guided surgery, for example, by providing better detection of tumours and their dimensions.
  
  
  OBJECTIVE
  To summarise and critically analyse the available evidence on image-guided surgery for genitourinary (GU) oncologic diseases.
  
  
  METHODS
  A comprehensive literature review was performed using PubMed and the Thomson Reuters Web of Science. In the free-text protocol, the following terms were applied: molecular imaging, genitourinary oncologic surgery, surgical navigation, image-guided surgery, and augmented reality. Review articles, editorials, commentaries, and letters to the editor were included if deemed to contain relevant information. We selected 79 articles according to the search strategy based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria and the IDEAL method.
  
  
  RESULTS
  MI techniques included optical imaging and fluorescent techniques, the augmented reality (AR) navigation system, magnetic resonance imaging spectroscopy, positron emission tomography, and single-photon emission computed tomography. Experimental studies on the AR navigation system were restricted to the detection and therapy of adrenal and renal malignancies and in the relatively infrequent cases of prostate cancer, whereas fluorescence techniques and optical imaging presented a wide application of intraoperative GU oncologic surgery. In most cases, image-guided surgery was shown to improve the surgical resectability of tumours.
  
  
  CONCLUSIONS
  Based on the evidence to date, image-guided surgery has promise in the near future for multiple GU malignancies. Further optimisation of targeted imaging agents, along with the integration of imaging modalities, is necessary to further enhance intraoperative GU oncologic surgery.
authors: Department of Urology and Renal Transplantation, Martin-Luther University, Halle an der Saale, Germany. Electronic address: francesco.greco@uk-halle.de.
authors: Francesco
authors: F
authors: Greco
authors: Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors: Jeffrey A
authors: JA
authors: Cadeddu
authors: USC Institute of Urology, Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
authors: Inderbir S
authors: IS
authors: Gill
authors: Glickman Urological & Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
authors: Jihad H
authors: JH
authors: Kaouk
authors: Department of Urology, Landesklinikum Korneuburg, Korneuburg, Austria.
authors: Mesut
authors: M
authors: Remzi
authors: Department of Urology, Mayo Clinic, Rochester, MN, USA.
authors: R Houston
authors: RH
authors: Thompson
authors: Department of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands.
authors: Fijs W B
authors: FW
authors: van Leeuwen
authors: Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors: Henk G
authors: HG
authors: van der Poel
authors: Department of Urology and Renal Transplantation, Martin-Luther University, Halle an der Saale, Germany.
authors: Paolo
authors: P
authors: Fornara
authors: Department of Urology, SLK Kliniken Heilbronn, University of Heidelberg, Heilbronn, Germany.
authors: Jens
authors: J
authors: Rassweiler
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005453:Fluorescence; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D057054:Molecular Imaging; D061848:Optical Imaging; D049268:Positron-Emission Tomography; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon; D001749:Urinary Bladder Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*
keywords: Augmented reality; Genitourinary oncologic surgery; Image-guided surgery; Molecular imaging; Surgical navigation