Fluorescence-guided surgery (FGS) was pioneered for glioma and is now established as the standard of care. Gliomas are infiltrative tumours with diffuse margins. FGS provides improved intra-operative identification of tumour margins based on tumour-specific emission visible to the operating surgeon, resulting in increased rates of gross total resection. Multiple fluorescence agents may be used including 5-ALA, fluorescein sodium, and indocyanine green (ICG). This review details the indication, required equipment, mechanism of action, evidence base, limitations, and regulatory issues for each fluorophore as utilised in current clinical practice. FGS for glioma is limited by a reliance on subjective interpretation of visible fluorescence, which is often not present in low-grade glioma (LGG) or at the infiltrative tumour margin. Consequently, there has been a drive to develop enhanced, objective FGS techniques utilising both quantitative fluorescence (QF) imaging systems and novel fluorophores. This review provides an overview of emerging QF imaging systems for FGS. The pipeline for novel fluorophore development is also summarised.
荧光引导手术（FGS）最初应用于胶质瘤，现已成为标准治疗手段。胶质瘤是一种具有弥漫性边界的浸润性肿瘤。FGS通过术者可见的肿瘤特异性荧光发射，提高了术中肿瘤边界的识别能力，从而提升了肿瘤全切率。目前可用的荧光剂包括5-氨基乙酰丙酸（5-ALA）、荧光素钠以及吲哚菁绿（ICG）。本综述详细阐述了当前临床实践中各类荧光剂的应用指征、所需设备、作用机制、证据基础、局限性及监管问题。胶质瘤FGS的局限性在于依赖术者对可见荧光的主观判读，而低级别胶质瘤（LGG）及浸润性肿瘤边缘常缺乏可见荧光。因此，业界正致力于开发结合定量荧光（QF）成像系统与新型荧光剂的增强型客观FGS技术。本综述概述了新兴的FGS定量荧光成像系统，并对新型荧光剂的研发管线进行了总结。
肿瘤(癌症)患者之家