Cerenkov luminescence imaging (CLI) for image-guided cancer surgery
Maarten Ruben Grootendorsta b c d✉, Massimiliano Cariatia b d, Ashutosh S. Kotharib c, David Solomon Tuche f, Arnie D. Purushothama b c d
- aDepartment of Research Oncology, 3rd Floor Bermondsey Wing, King's College London, London, SE1 9RT UK
- bDepartment of Breast Surgery, 3rd Floor Tower Wing, Guy's Hospital, London, SE1 9RT UK
- cDepartment of Breast Surgery, 3rd Floor Tower Wing, Guy's Hospital, London, SE1 9RT, UK
- dDepartment of Research Oncology, 3rd Floor Bermondsey Wing, King's College London, London, SE1 9RT, UK
- eLightpoint Medical Ltd, The Island, Moor Road, HP5 1NZ Chesham, UK
- fLightpoint Medical Ltd, The Island, Moor Road, HP5 1NZ, Chesham, UK
- ✉Corresponding author
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Abstract
Cerenkov luminescence imaging (CLI) is a novel molecular optical imaging technique based on the detection of optical Cerenkov photons emitted by positron emission tomography (PET) imaging agents. The ability to use clinically approved tumour-targeted tracers in combination with small-sized imaging equipment makes CLI a particularly interesting technique for image-guided cancer surgery. The past few years have witnessed a rapid increase in proof-of-concept preclinical studies in this field, and several clinical trials are currently underway. This article provides an overview of the basic principles of Cerenkov radiation and outlines the challenges of CLI-guided surgery for clinical use. The preclinical and clinical trial literature is examined including applications focussed on image-guided lymph node detection and Cerenkov luminescence endoscopy, and the ongoing clinical studies and technological developments are highlighted. By intraoperatively guiding the oncosurgeon towards more accurate and complete resections, CLI has the potential to transform current surgical practice, and improve oncological and cosmetic outcomes for patients.