title: The status of contemporary image-guided modalities in oncologic surgery.
abstract: OBJECTIVE
  To review the current trends in optical imaging to guide oncologic surgery.
  
  
  BACKGROUND
  Surgical resection remains the cornerstone of therapy for patients with early stage solid malignancies and more than half of all patients with cancer undergo surgery each year. The technical ability of the surgeon to obtain clear surgical margins at the initial resection remains crucial to improve overall survival and long-term morbidity. Current resection techniques are largely based on subjective and subtle changes associated with tissue distortion by invasive cancer. As a result, positive surgical margins occur in a significant portion of tumor resections, which is directly correlated with a poor outcome.
  
  
  METHODS
  A comprehensive review of studies evaluating optical imaging techniques is performed.
  
  
  RESULTS
  A variety of cancer imaging techniques have been adapted or developed for intraoperative surgical guidance that have been shown to improve functional and oncologic outcomes in randomized clinical trials. There are also a large number of novel, cancer-specific contrast agents that are in early stage clinical trials and preclinical development that demonstrate significant promise to improve real-time detection of subclinical cancer in the operative setting.
  
  
  CONCLUSIONS
  There has been an explosion of intraoperative imaging techniques that will become more widespread in the next decade.
authors.affiliation: *Departments of Surgery and †Radiology, The University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Eben L
authors.initials: EL
authors.lastname: Rosenthal
authors.forename: Jason M
authors.initials: JM
authors.lastname: Warram
authors.forename: Kirby I
authors.initials: KI
authors.lastname: Bland
authors.forename: Kurt R
authors.initials: KR
authors.lastname: Zinn
mesh_terms: D000622:Aminolevulinic Acid; D001932:Brain Neoplasms / Q000601:surgery; D004396:Coloring Agents; D003952:Diagnostic Imaging; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D007432:Intraoperative Period; D009369:Neoplasms / Q000473:pathology* / Q000601:surgery*; D061848:Optical Imaging; D017319:Photosensitizing Agents; D025321:Surgery, Computer-Assisted
chemical_list: D004396:Coloring Agents; D005456:Fluorescent Dyes; D017319:Photosensitizing Agents; D000622:Aminolevulinic Acid; D007208:Indocyanine Green