SavedAdd your journal

Journals / Eskisehir Medical Journal / 2026 / Volume: 7 Issue: 1

Advances in Intraoperative Probe Technology for Real-Time Tumor Delineation: A Ten-Year Review for Surgical Oncology

Gerçek Zamanlı Tümör Sınırlarının Belirlenmesi için İntraoperatif Prob Teknolojisindeki Gelişmeler: Cerrahi Onkoloji için On Yıllık Bir Derleme

Muhammed Emin Bedir(Karamanoğlu Mehmetbey Üniversitesi, Teknik Bilimler Meslek Yüksekokulu, Elektrik ve Enerji Bölümü,)0000-0002-4428-1241
Fuzuli Tuğrul(eskişehir Acıbadem hastanesi)0000-0001-9724-253X
Pages
—
Publication Date
2026-02-24
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: The development and integration of these technologies are transforming surgical decision-making from a subjective assessment to an approach guided by real-time, biologically relevant data, holding the promise to reduce PSM rates and shape the future of oncologic surgery.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Introduction: Achieving a "clean surgical margin" in oncologic surgery is a fundamental goal for preventing local recurrence and improving patient survival.
📊
Key Findings & Data:The persistence of high rates of positive surgical margins (PSMs) highlights the inadequacy of traditional visual and tactile assessment methods, driving the need for more precise, real-time intraoperative guidance technologies.
💡
Conclusion & Impact:Conclusion: The development and integration of these technologies are transforming surgical decision-making from a subjective assessment to an approach guided by real-time, biologically relevant data, holding the promise to reduce PSM rates and shape the future of oncologic surgery.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:surgical oncology · margins of excision · surgery computer-assisted

Abstract

Introduction: Achieving a "clean surgical margin" in oncologic surgery is a fundamental goal for preventing local recurrence and improving patient survival. The persistence of high rates of positive surgical margins (PSMs) highlights the inadequacy of traditional visual and tactile assessment methods, driving the need for more precise, real-time intraoperative guidance technologies. The clinical consequences of PSMs, including high re-excision rates that delay essential adjuvant therapies, underscore the urgency for such innovation. Methods: This review aims to comprehensively analyze the major intraoperative probe technologies that have transformed the practice of oncologic surgery over the last decade: radioguided surgery (RGS), fluorescence-guided surgery (FGS), advanced intraoperative ultrasound (IOUS), and spectroscopic probes. The physical principles, technological evolution, clinical applications, advantages, and limitations of each modality are comparatively analyzed. Results: Key trends examined include the transition from simple count-based detection to imaging in RGS; the paradigm shift in FGS from non-specific agents to biologically targeted and activatable "smart" probes; the revitalization of IOUS through integration with surgical navigation and functional techniques; and the potential of spectroscopy to provide in-situ "optical biopsy," which is heavily dependent on artificial intelligence (AI) for interpretation. It is emphasized that no single technology is the optimal solution for every clinical scenario; rather, the future lies in the intelligent orchestration of multimodal systems where AI serves as the central interpretive engine for comprehensive decision support. Conclusion: The development and integration of these technologies are transforming surgical decision-making from a subjective assessment to an approach guided by real-time, biologically relevant data, holding the promise to reduce PSM rates and shape the future of oncologic surgery.

Özet

Giriş: Onkolojik cerrahide "temiz cerrahi sınıra" ulaşmak, lokal nüksü önlemek ve hasta sağkalımını iyileştirmek için temel bir hedeftir. Yüksek pozitif cerrahi sınır (PCS) oranlarının devam etmesi, geleneksel görsel ve dokunsal değerlendirme yöntemlerinin yetersizliğini vurgulamakta ve daha hassas, gerçek zamanlı intraoperatif rehberlik teknolojilerine olan ihtiyacı ortaya koymaktadır. Temel adjuvan tedavileri geciktiren yüksek yeniden kesi oranları da dahil olmak üzere PCS'lerin klinik sonuçları, bu tür yeniliklerin aciliyetini vurgulamaktadır. Yöntemler: Bu derleme, son on yılda onkolojik cerrahi pratiğini dönüştüren başlıca intraoperatif prob teknolojilerini kapsamlı bir şekilde analiz etmeyi amaçlamaktadır: radyoguided cerrahi (RGC), floresan rehberli cerrahi (FRC), gelişmiş intraoperatif ultrason (İOUS) ve spektroskopik problar. Her bir yöntemin fiziksel prensipleri, teknolojik evrimi, klinik uygulamaları, avantajları ve sınırlamaları karşılaştırmalı olarak analiz edilmektedir. Bulgular: İncelenen temel eğilimler arasında RGC'de basit sayım tabanlı tespitten görüntülemeye geçiş; FRC'de spesifik olmayan ajanlardan biyolojik olarak hedeflenmiş ve aktive edilebilir "akıllı" problara doğru paradigma kayması; İOUS'un cerrahi navigasyon ve fonksiyonel tekniklerle entegrasyonu yoluyla yeniden canlandırılması; ve yorumlama için büyük ölçüde yapay zekaya (YZ) bağımlı olan spektroskopinin yerinde "optik biyopsi" sağlama potansiyeli yer almaktadır. Hiçbir tek teknolojinin her klinik senaryo için en uygun çözüm olmadığı; bunun yerine geleceğin, YZ'nin kapsamlı karar desteği için merkezi yorumlama motoru olarak hizmet ettiği çok modlu sistemlerin akıllı bir şekilde bir araya getirilmesinde yattığı vurgulanmaktadır. Sonuç: Bu teknolojilerin geliştirilmesi ve entegrasyonu, cerrahi karar verme sürecini subjektif bir değerlendirmeden gerçek zamanlı, biyolojik olarak anlamlı verilerle yönlendirilen bir yaklaşıma dönüştürmekte, PCS oranlarını düşürme ve onkolojik cerrahinin geleceğini şekillendirme vaadi taşımaktadır.

🔖

Cite This Article

Bedir, M. E., Tuğrul, F. (2026). Advances in Intraoperative Probe Technology for Real-Time Tumor Delineation: A Ten-Year Review for Surgical Oncology. Eskisehir Medical Journal, Volume: 7 Issue: 1. https://doi.org/10.48176/esmj.2026.248

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (71)

  1. Ogrinc N, Saudemont P, Takats Z, Salzet M, Fournier I. Cancer Surgery 2.0: Guidance by Real-Time Molecular Technologies. Trends Mol Med. 2021 Jun 1;27(6):602–15. doi:10.1016/j.molmed.2021.04.001 PubMed PMID: 33965341.
  2. Haddad AF, Aghi MK, Butowski N. Novel intraoperative strategies for enhancing tumor control: Future directions. Neuro Oncol. 2022 Nov 1;24(Suppl 6):S25–32. doi:10.1093/NEUONC/NOAC090, PubMed PMID: 36322096.
  3. Lauwerends LJ, van Driel PBAA, Baatenburg de Jong RJ, Hardillo JAU, Koljenovic S, Puppels G, et al. Real-time fluorescence imaging in intraoperative decision making for cancer surgery. Lancet Oncol. 2021 May 1;22(5):e186–95. doi:10.1016/S1470-2045(20)30600-8 PubMed PMID: 33765422.
  4. Dowling GP, Hehir CaM, Daly GR, Hembrecht S, Keelan S, Giblin K, et al. Diagnostic accuracy of intraoperative methods for margin assessment in breast cancer surgery: A systematic review & meta-analysis. Breast. 2024 Aug 1;76. doi:10.1016/j.breast.2024.103749 PubMed PMID: 38759577.
  5. Hitchcock CL, Chapman GJ, Mojzisik CM, Mueller JK, Martin EW. A Concept for Preoperative and Intraoperative Molecular Imaging and Detection for Assessing Extent of Disease of Solid Tumors. Oncol Rev. 2024 Jul 25; 18:1409410. doi:10.3389/OR.2024.1409410/XML
  6. Shah AS, Sylvester PT, Yahanda AT, Vellimana AK, Dunn GP, Evans J, et al. Intraoperative MRI for newly diagnosed supratentorial glioblastoma: a multicenter-registry comparative study to conventional surgery. J Neurosurg. 2020 Oct 9;135(2):505–14. doi:10.3171/2020.6.JNS19287 PubMed PMID: 33035996.
  7. Smith BL, Gadd MA, Lanahan CR, Rai U, Tang R, Rice-Stitt T, et al. Real-time, intraoperative detection of residual breast cancer in lumpectomy cavity walls using a novel cathepsin-activated fluorescent imaging system. Breast Cancer Res Treat. 2018 Sep 1;171(2):413. doi:10.1007/S10549-018-4845-4 PubMed PMID: 29948401.
  8. Gowrishankar S, Van Keulen S, Mattingly A, Tanaka H, Topf M, Mannion K, et al. Fluorescence-Guided Surgery for Assessing Margins in Head and Neck Cancer. JAMA Surg. 2025 Jun 18. doi:10.1001/JAMASURG.2025.1815,
  9. Lakany M, Sharif A, Alazzam M, Howell C, Mitchell S, Pappa C, et al. Intraoperative Ultrasound as a Decision-Making Tool in Modern Gynecologic Oncology. Journal of Personalized Medicine 2025, Vol 15, Page 296. 2025 Jul 8;15(7):296. doi:10.3390/JPM15070296
  10. Azari F, Kennedy G, Bernstein E, Hadjipanayis C, Vahrmeijer AL, Smith BL, et al. Intraoperative molecular imaging clinical trials: a review of 2020 conference proceedings. https://doi.org/101117/1JBO265050901. 2021 May 17;26(5):050901. doi:10.1117/1.JBO.26.5.050901 PubMed PMID: 34002555.
  11. Kapteijn BAE, Nieweg OE, Liem IH, Mooi WJ, Balm AJM, Muller SH, et al. Localizing the sentinel node in cutaneous melanoma: Gamma probe detection versus blue dye. Ann Surg Oncol. 1997;4(2):156–60. doi:10.1007/BF02303799, PubMed PMID: 9084853.
  12. Povoski SR, Neff RL, Mojzisik CM, O’Malley DM, Hinkle GH, Hall NC, et al. A comprehensive overview of radioguided surgery using gamma detection probe technology. World J Surg Oncol. 2009 Jan 27;7:11. doi:10.1186/1477-7819-7-11 PubMed PMID: 19173715.
  13. Zysk AM, Chen K, Gabrielson E, Tafra L, May Gonzalez EA, Canner JK, et al. Intraoperative Assessment of Final Margins with a Handheld Optical Imaging Probe During Breast-Conserving Surgery May Reduce the Reoperation Rate: Results of a Multicenter Study. Ann Surg Oncol. 2015 Oct 29;22(10):3356–62. doi:10.1245/S10434-015-4665-2/FIGURES/3 PubMed PMID: 26202553.
  14. Pashazadeh A, Friebe M. Radioguided surgery: Physical principles and an update on technological developments. Biomedizinische Technik. 2020 Feb 1;65(1):1–10. doi:10.1515/BMT-2018-0016, PubMed PMID: 31348751.
  15. Schupper AJ, Rao M, Mohammadi N, Baron R, Lee JYK, Acerbi F, et al. Fluorescence-Guided Surgery: A Review on Timing and Use in Brain Tumor Surgery. Front Neurol. 2021 Jun 16;12:682151. doi:10.3389/FNEUR.2021.682151 PubMed PMID: 34220688.
  16. Vaz SC, Oliveira C, Teixeira R, Arias-Bouda LMP, Cardoso MJ, DE GEUS-OEI LF. The current role of nuclear medicine in breast cancer. Br J Radiol. 2023 Sep 1;96(1149):20221153. doi:10.1259/BJR.20221153 PubMed PMID: 37097285.
  17. Zamora Amezcua KN, Andre I, Cisneros C, Fernando Cosme Rodríguez D, Perea Gómez Y, Antonio E, et al. Use of intraoperative ultrasound and surgical navigation in brainstem tumor resection: impact on accuracy, safety, and neurological outcomes-a systematic review. Int J Res Med Sci. 2025 Apr 29;13(5):2073–9. doi:10.18203/2320-6012.IJRMS20251313
  18. Meißner T, Cerbone LA, Russo P, Nahm W, Hesser J. Assessment of the axial resolution of a compact gamma camera with coded aperture collimator. EJNMMI Phys. 2024 Dec 1;11(1). doi:10.1186/S40658-024-00631-5,
  19. Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, et al. Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer. Ann Surg. 1998 May;227(5):645. doi:10.1097/00000658-199805000-00005 PubMed PMID: 9605656.
  20. Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al. Technical Details of Intraoperative Lymphatic Mapping for Early Stage Melanoma. Archives of Surgery. 1992;127(4):392–9. doi:10.1001/ARCHSURG.1992.01420040034005, PubMed PMID: 1558490.
  21. Perez-Andujar A, Pibida L. Performance of CdTe, HPGe and NaI(Tl) detectors for radioactivity measurements. Applied Radiation and Isotopes. 2004;60(1):41–7. doi:10.1016/j.apradiso.2003.10.006 PubMed PMID: 14687635.
  22. Buttacavoli A, Principato F, Gerardi G, Cascio D, Raso G, Bettelli M, et al. Incomplete Charge Collection at Inter-Pixel Gap in Low- and High-Flux Cadmium Zinc Telluride Pixel Detectors. Sensors (Basel). 2022 Feb 1;22(4):1441. doi:10.3390/S22041441 PubMed PMID: 35214342.
  23. Hoffman EJ, Tornai MP, Janecek M, Patt BE, Iwanczyk JS. Intraoperative probes and imaging probes. Eur J Nucl Med. 1999;26(8):913–35. doi:10.1007/S002590050468, PubMed PMID: 10436207.
  24. Kawamura K, Nakajima A, Ito S, Takahashi M, Yamaya T. Radiation source detection for the accurate location of lymph node metastases using robotic forceps-type coincidence radiation detector. International Journal of Computer Assisted Radiology and Surgery. 2025 Apr 1;20(4):677–86. doi:10.1007/S11548-024-03296-8/TABLES/1 PubMed PMID: 39623101.
  25. Ghosh D, Michalopoulos N V., Davidson T, Wickham F, Williams NR, Keshtgar MR. Sentinel node detection in early breast cancer with intraoperative portable gamma camera: UK experience. The Breast. 2017 Apr 1;32:53–9. doi:10.1016/J.BREAST.2016.12.013 PubMed PMID: 28033510.
  26. Farnworth AL, Bugby SL. Intraoperative Gamma Cameras: A Review of Development in the Last Decade and Future Outlook. J Imaging. 2023 May 1;9(5). doi:10.3390/JIMAGING9050102,
  27. Ibraheem MH, Gamil M, Tantawy A, Talaat O, Boutrrus R, Mohammed Mohammed Gomaa M. The Role of Intra-Operative Mobile Gamma Camera and Gamma Probe in Detection of Sentinel Lymph Node in Early Stage Breast Cancer. J Cancer Sci Clin Ther. 2019;03(04). doi:10.26502/JCSCT.5079037
  28. Quarta L, Stabile A, Chiti A, Montorsi F, Briganti A, Gandaglia G. Radioguided Surgery for Prostate Cancer. Eur Urol Focus. 2025 Jan 1;11(1):29–32. doi:10.1016/j.euf.2025.05.003 PubMed PMID: 40368719.
  29. De Feo MS, Frantellizzi V, De Sio L, Farcomeni A, De Vincentis G, Pani R. Role of PET gamma detection in radioguided surgery: a systematic review. Clin Transl Imaging. 2023 Dec 1;11(6):567–85. doi:10.1007/S40336-023-00559-3/FIGURES/4
  30. Krauel L, Pasten A, Gorostegui M, Mañé S, Martin Giménez MP, Coronas M, et al. Use of Radioguided Surgery for Small and Difficult-to-Locate Relapsed MIBG (+) High-Risk Neuroblastoma Lesions. Cancers (Basel). 2024 Oct 1;16(19). doi:10.3390/CANCERS16193348,
  31. Bedir ME, Thomadsen BR, Bednarz BP. Development and characterization of a handheld radiation detector for radio-guided surgery. Radiat Meas. 2020 Jul 1;135:106362. doi:10.1016/j.radmeas.2020.106362
  32. Khameneh ES, Amini MM, Kakaei S, Khanchi A. Preparation of dual-modality yttrium-90 radiolabeled nanoparticles for therapeutic investigation. Radiochim Acta. 2018;106(11):897–907. doi:10.1515/ract-2017-2901 WE - Science Citation Index Expanded (SCI-EXPANDED) PubMed PMID: rayyan-163150439.
  33. Reportsanddata. Fluorescence Image Guided Surgery System Market Market Share Analysis | Growth Forecast & Industry Outlook [Internet]. 2025 [cited 2025 Jul 17]. Report. Available from: https://www.reportsanddata.com/report-detail/fluorescence-image-guided-surgery-system-market
  34. Regmi M, Li Y, Wang Y, Liu W, Dai Y, Liu S, et al. Intraoperative fluorescence redefining neurosurgical precision. Int J Surg. 2025 Jan 1;111(1):998–1013. doi:10.1097/JS9.0000000000001847, PubMed PMID: 38913424.
  35. Cheng H, Xu H, Peng B, Huang X, Hu Y, Zheng C, et al. Illuminating the future of precision cancer surgery with fluorescence imaging and artificial intelligence convergence. npj Precision Oncology 2024 8:1. 2024 Sep 9;8(1):1–14. doi:10.1038/s41698-024-00699-3
  36. Mahalingam SM, Kularatne SA, Myers CH, Gagare P, Norshi M, Liu X, et al. Evaluation of Novel Tumor-Targeted Near-Infrared Probe for Fluorescence-Guided Surgery of Cancer. J Med Chem. 2018 Nov 8;61(21):9637–46. doi:10.1021/ACS.JMEDCHEM.8B01115/SUPPL_FILE/JM8B01115_SI_002.CSV PubMed PMID: 30296376.
  37. Litchinko A, Meyer J, Buhler L, Ris F, Adamina M. Fluorescence indocyanine green (ICG) for sentinel-lymph-node mapping in colorectal cancer: a systematic review. Langenbecks Arch Surg. 2025 Dec 1;410(1):202. doi:10.1007/S00423-025-03786-6 PubMed PMID: 40590942.
  38. Vuijk FA, Hilling DE, Mieog JSD, Vahrmeijer AL. Fluorescent‐guided surgery for sentinel lymph node detection in gastric cancer and carcinoembryonic antigen targeted fluorescent‐guided surgery in colorectal and pancreatic cancer. J Surg Oncol. 2018 Aug 1;118(2):315. doi:10.1002/JSO.25139 PubMed PMID: 30216455.
  39. Rodriguez B, Brown CS, Colan JA, Zhang JY, Huq S, Rivera D, et al. Fluorescence-Guided Surgery for Gliomas: Past, Present, and Future. Cancers 2025, Vol 17, Page 1837. 2025 May 30;17(11):1837. doi:10.3390/CANCERS17111837
  40. Crawford KL, Pacheco F V., Lee YJ, Hom M, Rosenthal EL, Nguyen QT, et al. A Scoping Review of Ongoing Fluorescence-Guided Surgery Clinical Trials in Otolaryngology. Laryngoscope. 2022 Jan 1;132(1):36–44. doi:10.1002/LARY.29891 PubMed PMID: 34633092.
  41. Bortot B, Mangogna A, Di Lorenzo G, Stabile G, Ricci G, Biffi S. Image-guided cancer surgery: a narrative review on imaging modalities and emerging nanotechnology strategies. Journal of Nanobiotechnology 2023 21:1. 2023 May 18;21(1):1–23. doi:10.1186/S12951-023-01926-Y PubMed PMID: 37202750.
  42. Paraboschi I, Farneti F, Jannello L, Manzoni G, Berrettini A, Mantica G. Narrative review on applications of fluorescence-guided surgery in adult and paediatric urology. AME Med J. 2022 Jun 1;7(0). doi:10.21037/AMJ-20-194/COIF
  43. Goto M, Ryoo I, Naffouje S, Mander S, Christov K, Wang J, et al. Image-guided surgery with a new tumour-targeting probe improves the identification of positive margins. EBioMedicine. 2022 Feb 1;76. doi:10.1016/j.ebiom.2022.103850 PubMed PMID: 35108666.
  44. Fadel MG, Zonoobi E, Rodríguez-Luna MR, Mishima K, Ris F, Diana M, et al. Efficacy and Safety of Fluorescence-Guided Surgery Compared to Conventional Surgery in the Management of Colorectal Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel). 2024 Oct 1;16(19). doi:10.3390/CANCERS16193377,
  45. Kennedy GT, Holt DE, Azari FS, Bernstein E, Nadeem B, Chang A, et al. A Cathepsin-Targeted Quenched Activity–Based Probe Facilitates Enhanced Detection of Human Tumors during Resection. Clinical Cancer Research. 2022 Sep 1;28(17):3729–41. doi:10.1158/1078-0432.CCR-22-1215, PubMed PMID: 35792882.
  46. Zahed Z, Hadi R, Imanzadeh G, Ahmadian Z, Shafiei S, Zadeh AZ, et al. Recent advances in fluorescence nanoparticles “quantum dots” as gene delivery system: A review. Int J Biol Macromol. 2024 Jan 1;254:127802. doi:10.1016/J.IJBIOMAC.2023.127802 PubMed PMID: 37918598.
  47. Dixon L, Lim A, Grech-Sollars M, Nandi D, Camp S. Intraoperative ultrasound in brain tumor surgery: A review and implementation guide. Neurosurg Rev. 2022 Aug 1;45(4):2503. doi:10.1007/S10143-022-01778-4 PubMed PMID: 35353266.
  48. Yeole U, Singh V, Mishra A, Shaikh S, Shetty P, Moiyadi A. Navigated intraoperative ultrasonography for brain tumors: A pictorial essay on the technique, its utility, and its benefits in neuro-oncology. Ultrasonography. 2020 Oct 1;39(4):394–406. doi:10.14366/USG.20044,
  49. Palavani LB, Ferreira MY, Borges PGLB, Bandeira L, da Silva Semione G, Almeida M V., et al. Ultrasound-Guided Resection of High-Grade Gliomas: A Single-Arm Meta-Analysis. World Neurosurg. 2024 Jun 1;186:17–26. doi:10.1016/J.WNEU.2024.03.033 PubMed PMID: 38490442.
  50. Kearns KN, Sokolowski JD, Chadwell K, Chandler M, Kiernan T, Prada F, et al. The role of contrast-enhanced ultrasound in neurosurgical disease. Neurosurg Focus. 2019 Dec 1;47(6):E8. doi:10.3171/2019.9.FOCUS19624 PubMed PMID: 31786558.
  51. Kupke LS, Dropco I, Götz M, Kupke P, Jung F, Stroszczynski C, et al. Contrast-Enhanced Intraoperative Ultrasound Shows Excellent Performance in Improving Intraoperative Decision-Making. Life 2024, Vol 14, Page 1199. 2024 Sep 22;14(9):1199. doi:10.3390/LIFE14091199
  52. Prada F, Del Bene M, Rampini A, Mattei L, Casali C, Vetrano IG, et al. Intraoperative strain elastosonography in brain tumor surgery. Operative Neurosurgery. 2019 Aug 1;17(2):227–36. doi:10.1093/ONS/OPY323, PubMed PMID: 30496587.
  53. Kennedy KM, Zilkens R, Allen WM, Foo KY, Fang Q, Chin L, et al. Diagnostic accuracy of quantitative micro-elastography for margin assessment in breast-conserving surgery. Cancer Res. 2020 Apr 15;80(8):1773–83. doi:10.1158/0008-5472.CAN-19-1240,
  54. Parisi S, Ruggiero R, Gualtieri G, Volpe ML, Rinaldi S, Nesta G, et al. Combined LOCalizerTM and Intraoperative Ultrasound Localization: First Experience in Localization of Non-palpable Breast Cancer. In Vivo (Brooklyn). 2021 May 1;35(3):1669–76. doi:10.21873/INVIVO.12426 PubMed PMID: 33910851.
  55. Cepeda S, Esteban-Sinovas O, Romero R, Singh V, Shett P, Moiyadi A, et al. Real-time brain tumor detection in intraoperative ultrasound: From model training to deployment in the operating room. Comput Biol Med. 2025 Jul 1;193:110481. doi:10.1016/J.COMPBIOMED.2025.110481 PubMed PMID: 40449046.
  56. de Kleijn BJ, Heldens GTN, Herruer JM, Sier CFM, Piazza C, de Bree R, et al. Intraoperative Imaging Techniques to Improve Surgical Resection Margins of Oropharyngeal Squamous Cell Cancer: A Comprehensive Review of Current Literature †. Cancers (Basel). 2023 Feb 1;15(3). doi:10.3390/CANCERS15030896,
  57. Santoro M, Strolin S, Paolani G, Giuseppe DG, Bartoloni A, Giacometti C, et al. Recent Applications of Artificial Intelligence in Radiotherapy: Where We Are and Beyond. Applied Sciences (Switzerland). 2022 Apr 1;12(7):3223. doi:10.3390/APP12073223/S1
  58. Thill M. MarginProbe®: intraoperative margin assessment during breast conserving surgery by using radiofrequency spectroscopy. Expert Rev Med Devices. 2013 May;10(3):301–15. doi:10.1586/ERD.13.5 PubMed PMID: 23668703.
  59. Windisch O, Diana M, Tilki D, Marra G, Martini A, Valerio M. Intraoperative technologies to assess margin status during radical prostatectomy – a narrative review. Prostate Cancer and Prostatic Diseases 2024 28:1. 2024 Jul 18;28(1):81–8. doi:10.1038/s41391-024-00868-2 PubMed PMID: 39025926.
  60. Privitera L, Paraboschi I, Cross K, Giuliani S. Above and Beyond Robotic Surgery and 3D Modelling in Paediatric Cancer Surgery. Front Pediatr. 2021 Dec 20;9. doi:10.3389/FPED.2021.777840,
  61. Fransvea G, Moccia S, Bianchi F, Ciuti G, Menciassi A, Capineri L, et al. Intraoperative-technologies advancements in automated cancer detection: A narrative review. 2021 IEEE International Workshop on Metrology for Industry 40 and IoT, MetroInd 40 and IoT 2021 - Proceedings. 2021 Jun 7;128–33. doi:10.1109/METROIND4.0IOT51437.2021.9488459
  62. Daoust F, Dallaire F, Tavera H, Ember K, Guiot MC, Petrecca K, et al. Preliminary study demonstrating cancer cells detection at the margins of whole glioblastoma specimens with Raman spectroscopy imaging. Scientific Reports 2025 15:1. 2025 Feb 22;15(1):1–15. doi:10.1038/s41598-025-87109-1 PubMed PMID: 39987144.
  63. Pepa GM Della, Ius T, La Rocca G, Gaudino S, Isola M, Pignotti F, et al. 5-Aminolevulinic Acid and Contrast-Enhanced Ultrasound: The Combination of the Two Techniques to Optimize the Extent of Resection in Glioblastoma Surgery. Neurosurgery. 2020 Jun 1;86(6):E529–40. doi:10.1093/NEUROS/NYAA037, PubMed PMID: 32186345.
  64. Sutton PA, van Dam MA, Cahill RA, Mieog S, Polom K, Vahrmeijer AL, et al. Fluorescence-guided surgery: comprehensive review. BJS Open. 2023 Jun 1;7(3). doi:10.1093/BJSOPEN/ZRAD049, PubMed PMID: 37183598.
  65. Koç ZP, Kara PPÖ, Berkeşoǧlu M, Akça T. First experience with a new technique: Portable gamma camera usage for sentinel lymph node identification in a patient with breast cancer. Turk J Surg. 2018;34(1):57. doi:10.5152/UCD.2016.3654 PubMed PMID: 29756109.
  66. Abolaban FA. Review of recent impacts of artificial intelligence for radiation therapy procedures. Radiation Physics and Chemistry. 2023 Jan 1;202:110469. doi:10.1016/J.RADPHYSCHEM.2022.110469
  67. Sheng K. Artificial intelligence in radiotherapy: a technological review. Front Med. 2020 Aug 1;14(4):431–49. doi:10.1007/S11684-020-0761-1, PubMed PMID: 32728877.
  68. Lambin P, Leijenaar RTH, Deist TM, Peerlings J, De Jong EEC, Van Timmeren J, et al. Radiomics: The bridge between medical imaging and personalized medicine. Nat Rev Clin Oncol. 2017 Dec 1;14(12):749–62. doi:10.1038/NRCLINONC.2017.141, PubMed PMID: 28975929.
  69. Gillies RJ, Kinahan PE, Hricak H. Radiomics: Images are more than pictures, they are data. Radiology. 2016 Feb 1;278(2):563–77. doi:10.1148/RADIOL.2015151169, PubMed PMID: 26579733.
  70. Valdés PA, Roberts DW, Lu FK, Golby A. Optical technologies for intraoperative neurosurgical guidance. Neurosurg Focus. 2016 Mar 1;40(3):E8. doi:10.3171/2015.12.FOCUS15550 PubMed PMID: 26926066.
  71. Kawamura K, Nakajima A, Ito S, Takahashi M, Yamaya T. Radiation source detection for the accurate location of lymph node metastases using robotic forceps-type coincidence radiation detector. International Journal of Computer Assisted Radiology and Surgery. 2025 Apr 1;20(4):677–86. doi:10.1007/S11548-024-03296-8/TABLES/1 PubMed PMID: 39623101.