Interventional molecular imaging, a hybrid approach

Accurate detection of tumor tissue is a key feature in the diagnosis of cancer, and surgery is one of the major pillars in further management of the disease. Using preoperatively obtained images, the area of interest can be linked to the anatomy of the patient, enabling planning of the surgical intervention. During surgical exploration morbidity may be caused by the unnecessary removal of healthy tissue and/or the unintentional damage to delicate anatomical structures. Furthermore, the inability to completely excise the cancerous tissue increases the need for invasive re-excisions. More accurate surgical visualization of the area__s of interest can supplement the surgeons eyes and help improve surgical outcome. Accurate preoperative identification, surgical planning, and intraoperative visualization can be integrated using hybrid imaging agents that contain both a radioand fluorescent label. This hybrid interventional molecular imaging concept was initially validated in sentinel lymph node (SLN) biopsies, but can be further expanded by the implementation of imaging agents that specifically visualize tumor cells. In this thesis both the preclinical and clinical introduction of this hybrid concept is described.J.E. Jurriaanse stichting, Intuitive surgical, Oncovision, Storz endoscopesUBL - phd migration 201