{"entity":{"id":"fluorescence-guided-surgery","kind":"technology","name":"Fluorescence-guided surgery","aka":[],"tldr":"Injecting a dye that makes tumour glow so the surgeon can see exactly where to cut.","summary":"In fluorescence-guided surgery a tumour-selective fluorophore accumulates in the tumour and is imaged with near-infrared camera systems, so the surgeon can see disease that is invisible under white light. 5-ALA in glioma increases complete resection rates; pafolacianine (Cytalux) finds occult ovarian and lung lesions; pegulicianine (Lumisight, 2024) detects residual breast cancer in the lumpectomy cavity. The clinical payoff is fewer positive margins and re-operations. Targeted probes against EGFR, PSMA, and CEA are in phase 2-3 and would extend the approach to more tumour types. The limitation is millimetre depth penetration, so the dye shows surface disease and cannot see deep into tissue. The simple version is that a dye makes the tumour glow so the surgeon knows exactly where to cut.","status":"established","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Fluorescence_image-guided_surgery","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Fluorescence_image-guided_surgery"}],"tags":[],"related":[],"cancers":[],"sections":["surgery","imaging"],"technologies":["optical-imaging"],"targets":[],"drugs":[],"companies":["vergent-bioscience","photonamic","blaze-bioscience"],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A tumour-selective fluorophore accumulates in the tumour and is imaged with near-infrared camera systems.","strengths":["Fewer positive margins and re-operations"],"limitations":["Millimetre depth penetration"]},"route":"/technologies/fluorescence-guided-surgery/","neighbours":{"section":[{"id":"imaging","kind":"section","name":"Imaging","route":"/fronts/imaging/"},{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"intraoperative-fluorescence-imaging-systems","kind":"technology","name":"Intraoperative fluorescence and Cerenkov imaging systems (SPY, Firefly, LumiSystem, LightPath)","route":"/technologies/intraoperative-fluorescence-imaging-systems/"},{"id":"intraoperative-mri-ct","kind":"technology","name":"Intraoperative MRI and CT","route":"/technologies/intraoperative-mri-ct/"},{"id":"optical-imaging","kind":"technology","name":"Optical & fluorescence imaging","route":"/technologies/optical-imaging/"},{"id":"quantum-dot-imaging","kind":"technology","name":"Quantum-dot and molecular ultrasound imaging agents","route":"/technologies/quantum-dot-imaging/"},{"id":"sonodynamic-therapy","kind":"technology","name":"Sonodynamic therapy","route":"/technologies/sonodynamic-therapy/"},{"id":"surgical-robot-platforms","kind":"technology","name":"Surgical robots: da Vinci, Hugo, Versius and single-port systems","route":"/technologies/surgical-robot-platforms/"}],"company":[{"id":"blaze-bioscience","kind":"company","name":"Blaze Bioscience","route":"/companies/blaze-bioscience/"},{"id":"carl-zeiss-meditec","kind":"company","name":"Carl Zeiss Meditec","route":"/companies/carl-zeiss-meditec/"},{"id":"karl-storz","kind":"company","name":"Karl Storz","route":"/companies/karl-storz/"},{"id":"lumicell","kind":"company","name":"Lumicell","route":"/companies/lumicell/"},{"id":"on-target-laboratories","kind":"company","name":"On Target Laboratories","route":"/companies/on-target-laboratories/"},{"id":"photonamic","kind":"company","name":"photonamic","route":"/companies/photonamic/"},{"id":"sbi-pharmaceuticals","kind":"company","name":"SBI Pharmaceuticals","route":"/companies/sbi-pharmaceuticals/"},{"id":"stryker","kind":"company","name":"Stryker","route":"/companies/stryker/"},{"id":"vergent-bioscience","kind":"company","name":"Vergent Bioscience","route":"/companies/vergent-bioscience/"}],"cancer":[{"id":"glioblastoma","kind":"cancer","name":"Glioma & glioblastoma","route":"/cancers/glioblastoma/"}],"term":[{"id":"extent-of-resection","kind":"term","name":"Extent of resection (RANO resect classes)","route":"/terms/extent-of-resection/"},{"id":"sentinel-lymph-node-biopsy","kind":"term","name":"Sentinel node biopsy","route":"/terms/sentinel-lymph-node-biopsy/"}],"trial":[{"id":"nct05804370","kind":"trial","name":"Gleolan for Visualization of Newly Diagnosed or Recurrent Ovarian Cancer (OVA-302)","route":"/trials/nct05804370/"},{"id":"insite","kind":"trial","name":"INSITE","route":"/trials/insite/"},{"id":"targeted-axillary-dissection-md-anderson","kind":"trial","name":"Targeted axillary dissection (MD Anderson prospective study)","route":"/trials/targeted-axillary-dissection-md-anderson/"}],"person":[{"id":"behnam-badie","kind":"person","name":"Behnam Badie","route":"/people/behnam-badie/"},{"id":"mitchel-berger","kind":"person","name":"Mitchel S. Berger","route":"/people/mitchel-berger/"}],"bottleneck":[{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"}],"idea":[{"id":"idea-fund-intraoperative-imaging-trials","kind":"idea","name":"A pragmatic trial network for intraoperative margin tools, paid on margin reduction","route":"/ideas/idea-fund-intraoperative-imaging-trials/"},{"id":"idea-fund-device-and-technique-translation-fund","kind":"idea","name":"A translation fund for academic surgical devices and radiotherapy technology","route":"/ideas/idea-fund-device-and-technique-translation-fund/"},{"id":"idea-fund-surgical-ai-robotics-evaluation","kind":"idea","name":"An independent evaluation unit for surgical robots and AI, paid on evidence","route":"/ideas/idea-fund-surgical-ai-robotics-evaluation/"},{"id":"idea-moon-image-guided-surgery-everywhere","kind":"idea","name":"Real-time margin assessment and image-guided surgery as the global standard","route":"/ideas/idea-moon-image-guided-surgery-everywhere/"}],"drug":[{"id":"aminolevulinic-acid-gleolan","kind":"drug","name":"5-Aminolevulinic acid (oral, for glioma surgery)","route":"/drugs/aminolevulinic-acid-gleolan/"},{"id":"pafolacianine","kind":"drug","name":"Pafolacianine","route":"/drugs/pafolacianine/"},{"id":"pegulicianine","kind":"drug","name":"Pegulicianine","route":"/drugs/pegulicianine/"}],"institution":[{"id":"arpa-h","kind":"institution","name":"Advanced Research Projects Agency for Health","route":"/institutions/arpa-h/"},{"id":"chang-gung-memorial-hospital","kind":"institution","name":"Chang Gung Memorial Hospital","route":"/institutions/chang-gung-memorial-hospital/"},{"id":"uci-chao","kind":"institution","name":"Chao Family Comprehensive Cancer Center, UC Irvine","route":"/institutions/uci-chao/"},{"id":"esso","kind":"institution","name":"European Society of Surgical Oncology","route":"/institutions/esso/"},{"id":"purdue-cancer-research","kind":"institution","name":"Purdue Institute for Cancer Research","route":"/institutions/purdue-cancer-research/"},{"id":"sso","kind":"institution","name":"Society of Surgical Oncology","route":"/institutions/sso/"}],"pathway":[{"id":"invasion-ecm-degradation","kind":"pathway","name":"Invasion: proteases, adhesion & the invasive front","route":"/pathways/invasion-ecm-degradation/"}],"roadmap":[{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}]}}