Image guided surgery using near-infrared fluorescence: road to clinical translation of novel probes for real time tumor visualization

Fluorescence imaging is a novel intraoperative technique for guiding oncologic surgeons toward radical tumor resections. Application of various fluorescent agents in exploratory clinical trials has already yielded promising results. The field of fluorescence imaging must now move beyond the proof-of-concept phase toward clinical application and implementation. This shift encompasses several hurdles, including standardization, advanced-phase study endpoints, regulatory affairs and routine implementation, which need to be addressed by the community in close collaboration with all stakeholders. These challenges, and the possible actions to overcome them and promote and accelerate clinical implementation of fluorescence imaging, are summarized in this paper.