Real-Time Fluorescence-Enhanced Imaging as an Aid to Surgery in Ovarian Cancer

Epithelial ovarian cancer has the highest mortality among all gynecologic cancers. Due to the nonspecific nature of its symptoms, most women with ovarian cancer present with advanced stage disease, resulting in a poor overall prognosis. Surgical tumor debulking is one of the most effective interventions to improve the outcome for these patients. However, reducing the amount of residual tumor to microscopic levels is often complicated by the small size of the implants and poor visual contrast between small tumor implants and normal tissue under white light conditions found in most operating rooms. Therefore, one proposed method to improve the resection of metastatic ovarian cancer is to apply tumor-targeted optical fluorophores that could identify sites of metastasis with high sensitivity and specificity, providing the surgeon with an intraoperative guide to tumor location. Herein, we describe a novel method of identifying ovarian cancer metastases using fluorescent tagging and a real-time fluorescence camera that allows the resection of metastatic disease that would otherwise not be visible to the surgeon.