Radioguided surgery (RGS) is the use of radiation detection probes and handheld gamma cameras in surgery rooms to identify radioactively labeled lesions inside the body with an aim to improve surgical outcome. In today’s surgery, application of these devices is a well-established practice, which provides surgeons with real-time information to guide them to the site of a lesion. In recent years, there have been several major improvements in the technology and design of gamma probes and handheld gamma cameras, enhancing their applications in surgical practices. Handheld gamma cameras, for example, are now moving from single-modality to dual-modality scanners that add anatomical data to the physiologic data, and with that provide more clinical information of the tissue under study. Also, in the last decade, a radioguided surgical technique based on the Cerenkov radiation was introduced, with more improved sensitivity in identifying radioactively labeled lesions. Additionally, recent advances in hybrid tracers have led to more efficient detection of lesions labeled with these tracers. Besides, it seems that combining medical robotics and augmented reality technology with current radioguided surgical practices potentially will change the delivery and performance of RGS in the near future. The current paper aims to give an overview of the physics of RGS and summarizes recent advances in this field that have a potential to improve the application of radioguided surgical procedures in the management of cancer.

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无线电引导手术：物理原理和技术发展的更新

无线电引导手术 (RGS) 是在手术室使用辐射探测探头和手持式伽马相机来识别体内放射性标记的病变，以改善手术结果。在今天的手术中，这些设备的应用是一种成熟的实践，它为外科医生提供实时信息以引导他们到达病变部位。近年来，伽马探头和手持式伽马相机的技术和设计有了几项重大改进，增强了它们在手术实践中的应用。例如，手持式伽马相机现在正从单模态扫描仪转向双模态扫描仪，将解剖学数据添加到生理学数据中，从而提供更多关于研究组织的临床信息。此外，在过去的十年中，引入了基于切伦科夫辐射的放射引导手术技术，在识别放射性标记病变方面具有更高的灵敏度。此外，混合示踪剂的最新进展导致更有效地检测用这些示踪剂标记的病变。此外，似乎将医疗机器人和增强现实技术与当前的无线电引导手术实践相结合，可能会在不久的将来改变 RGS 的交付和性能。本论文旨在概述 RGS 的物理学，并总结该领域的最新进展，这些进展有可能改善放射引导外科手术在癌症治疗中的应用。混合示踪剂的最新进展导致更有效地检测用这些示踪剂标记的病变。此外，似乎将医疗机器人和增强现实技术与当前的无线电引导手术实践相结合，可能会在不久的将来改变 RGS 的交付和性能。本论文旨在概述 RGS 的物理学，并总结该领域的最新进展，这些进展有可能改善放射引导外科手术在癌症治疗中的应用。混合示踪剂的最新进展导致更有效地检测用这些示踪剂标记的病变。此外，似乎将医疗机器人和增强现实技术与当前的无线电引导手术实践相结合，可能会在不久的将来改变 RGS 的交付和性能。本论文旨在概述 RGS 的物理学，并总结该领域的最新进展，这些进展有可能改善放射引导外科手术在癌症治疗中的应用。