Intraoperative molecular imaging (IMI) has recently emerged as an important tool in the armamentarium of surgical oncologists. IMI allows real-time assessment of oncologic resection quality, margin assessment, and occult disease detection during real-time surgery. Numerous tracers have now been developed for use in IMI-guided tissue sampling. Fluorochromes localize to the tumor by taking advantage of their disorganized capillary milieu, overexpressed receptors, or upregulated enzymes. Although fluorescent tracers can suffer from issues of autofluorescence and lack of depth penetration, these challenges are being addressed through hybrid radioactive/fluorescent tracers and new tracers that fluoresce in the near-infrared (NIR-II [wavelength > 1,000 nm]) range. IMI is already being used to treat numerous cancers, with demonstrated improvement in cancer recurrence and patient outcomes without incurring significant burden on either clinicians or patients. In this comprehensive review, we discuss history, mechanism, current oncologic applications, and future directions of IMI-guided optical biopsy.

术中分子成像 (IMI) 最近已成为外科肿瘤学家的重要工具。IMI 允许在实时手术期间实时评估肿瘤切除质量、边缘评估和隐匿性疾病检测。现在已经开发了许多示踪剂用于 IMI 引导的组织取样。荧光染料利用其杂乱无章的毛细血管环境、过度表达的受体或上调的酶定位于肿瘤。尽管荧光示踪剂可能会遇到自发荧光和缺乏深度穿透的问题，但这些挑战正在通过混合放射性/荧光示踪剂和在近红外（NIR-II [波长 > 1,000 nm]）范围内发出荧光的新型示踪剂来解决。IMI 已经被用于治疗多种癌症，证明可以改善癌症复发和患者预后，而不会给临床医生或患者带来重大负担。在这篇综合综述中，我们讨论了 IMI 引导的光学活检的历史、机制、当前肿瘤学应用和未来方向。