Intraoperative Molecular Imaging

What Is Intraoperative Molecular Imaging?

Intraoperative molecular imaging relies on an injectable dye that has been specially engineered to accumulate in cancerous tissues, much more so than normal tissues. 

Penn Medicine currently offering patients the opportunity to enroll in a clinical trials where surgeons and oncologists at the Center for Precision Surgery are testing the efficacy of these dyes. 

How Does Intraoperative Molecular Imaging Work?

Before surgery, patients are injected with a dye that causes cancer cells that might normally be invisible to CT scans to “glow” under near-infrared light. (The same process was followed for all patients involved in the clinical trial.)

The tumors strongly glow under near-infrared cameras, guiding surgeons to cancerous tissue in areas previously undetected. The results to date have been extraordinary. 

"The biggest challenge for thoracic surgeons is finding smaller nodules and making smaller incisions to remove them. When we started using the dye, we could start to see smaller nodules than we ever could before. Now, we can alter our incisions based on the location and type of tumor. We can start making incisions directly over the tumor, whereas, before, we would make some generic decisions." - Sunil Singhal

This technique may offer great promise to physicians -- a strategy that could allow greater precision and accuracy in removing the entire tumor. Intraoperative molecular imaging would help with early detection of small tumors and hopefully better treatment success for cancer patients. 

What Are the Benefits of Intraoperative Molecular Imaging?

There are two main benefits to the patient. 

The first benefit is that by seeing where the tumor is located, the surgeon can make sure to get it all out. This investigational method can make surgery safer for the patient if it allows the surgeons to cut out only what they need to take out, and nothing else. Penn surgeons believe that this approach will prove to be more precise. 

Another benefit we have seen is the dye’s ability to “find” cancerous lymph nodes. This is especially important because identification of disease in the lymph nodes tells the oncologist that you may need to give the patient more chemotherapy, or that their cancer has progressed. This technology may also allow us to identify which lymph nodes we should take out and which lymph nodes we should leave in.

Other benefits include:

  • Complete resection of tumors with negative margins
  • Reduction in the risk of local recurrence
  • Identification of cancerous lymph nodes
  • Introduction of optical biopsies, or real-time diagnostics, in the operating room
  • More accurate staging
  • Early detection of pre-cancerous disease
  • Minimization of unnecessary tissue removal
  • Shortened hospital stays
  • Increase on positive outcomes