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Molecular Image-guided Surgery in Gynaecological Cancer: Where Do We Stand?

Abstract

Purpose: The aim of this review is to give an overview of the current status of molecular image-guided surgery in gynaecological malignancies, from both clinical and technological points of view.

Methods: A narrative approach was taken to describe the relevant literature, focusing on clinical applications of molecular image-guided surgery in gynaecology, preoperative imaging as surgical roadmap, and intraoperative devices.

Results: The most common clinical application in gynaecology is sentinel node biopsy (SNB). Other promising approaches are receptor-target modalities and occult lesion localisation. Preoperative SPECT/CT and PET/CT permit a roadmap for adequate surgical planning. Intraoperative detection modalities span from 1D probes to 2D portable cameras and 3D freehand imaging.

Conclusion: After successful application of radio-guided SNB and SPECT, innovation is leaning towards hybrid modalities, such as hybrid tracer and fusion of imaging approaches including SPECT/CT and PET/CT. Robotic surgery, as well as augmented reality and virtual reality techniques, is leading to application of these innovative technologies to the clinical setting, guiding surgeons towards a precise, personalised, and minimally invasive approach.

Citing Articles

ASO Authors Reflections: Innovations for Intraoperative Lymph Node Imaging in the Era of Digital Surgery in Gynecological Cancers.

Pavone M, Teodorico E, Bizzarri N, Innocenzi C, Rosati A, Zorzi M Ann Surg Oncol. 2025; .

PMID: 39987386 DOI: 10.1245/s10434-025-17047-9.

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