# Fluorescence-guided surgery

Source: https://onco.cc/technologies/fluorescence-guided-surgery/  
OnCo record `fluorescence-guided-surgery` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Injecting a dye that makes tumour glow so the surgeon can see exactly where to cut.

## Summary

In fluorescence-guided surgery a tumour-selective fluorophore accumulates in the tumour and is imaged with near-infrared camera systems, so the surgeon can see disease that is invisible under white light. 5-ALA in glioma increases complete resection rates; pafolacianine (Cytalux) finds occult ovarian and lung lesions; pegulicianine (Lumisight, 2024) detects residual breast cancer in the lumpectomy cavity. The clinical payoff is fewer positive margins and re-operations. Targeted probes against EGFR, PSMA, and CEA are in phase 2-3 and would extend the approach to more tumour types. The limitation is millimetre depth penetration, so the dye shows surface disease and cannot see deep into tissue. The simple version is that a dye makes the tumour glow so the surgeon knows exactly where to cut.

## Fields

- Kind: Technology
- Status: established
- Last checked: 2026-09-04
- Tags: precision
- Principle: A tumour-selective fluorophore accumulates in the tumour and is imaged with near-infrared camera systems.
- Strengths: Fewer positive margins and re-operations
- Limitations: Millimetre depth penetration

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Fluorescence_image-guided_surgery
- Wikipedia: https://en.wikipedia.org/wiki/Fluorescence_image-guided_surgery

## Connected records

- fronts: [Imaging](https://onco.cc/fronts/imaging/), [Surgery & Interventional](https://onco.cc/fronts/surgery/)
- technologies: [Intraoperative fluorescence and Cerenkov imaging systems (SPY, Firefly, LumiSystem, LightPath)](https://onco.cc/technologies/intraoperative-fluorescence-imaging-systems/), [Intraoperative margin assessment in breast-conserving surgery](https://onco.cc/technologies/intraoperative-margin-assessment-breast/), [Intraoperative MRI and CT](https://onco.cc/technologies/intraoperative-mri-ct/), [Optical & fluorescence imaging](https://onco.cc/technologies/optical-imaging/), [Quantum-dot and molecular ultrasound imaging agents](https://onco.cc/technologies/quantum-dot-imaging/), [Sonodynamic therapy](https://onco.cc/technologies/sonodynamic-therapy/), [Surgical robots: da Vinci, Hugo, Versius and single-port systems](https://onco.cc/technologies/surgical-robot-platforms/)
- companies: [Antelope Surgical Solutions](https://onco.cc/companies/antelope-surgical-solutions/), [Blaze Bioscience](https://onco.cc/companies/blaze-bioscience/), [Carl Zeiss Meditec](https://onco.cc/companies/carl-zeiss-meditec/), [FluoGuide](https://onco.cc/companies/fluoguide/), [Karl Storz](https://onco.cc/companies/karl-storz/), [Lumicell](https://onco.cc/companies/lumicell/), [On Target Laboratories](https://onco.cc/companies/on-target-laboratories/), [photonamic](https://onco.cc/companies/photonamic/), [SBI Pharmaceuticals](https://onco.cc/companies/sbi-pharmaceuticals/), [Stryker](https://onco.cc/companies/stryker/), [Vergent Bioscience](https://onco.cc/companies/vergent-bioscience/)
- trials: [Efficacy and Safety of a Single Dose of LS301-IT for Fluorescence Intraoperative Molecular Imaging (IMI) for Patients Undergoing Lung Cancer Resection for Non Small Cell Lung Cancer](https://onco.cc/trials/nct07276789/), [Gleolan for Visualization of Newly Diagnosed or Recurrent Ovarian Cancer (OVA-302)](https://onco.cc/trials/nct05804370/), [INSITE](https://onco.cc/trials/insite/), [Targeted axillary dissection (MD Anderson prospective study)](https://onco.cc/trials/targeted-axillary-dissection-md-anderson/)
- cancers: [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/)
- terms: [Extent of resection (RANO resect classes)](https://onco.cc/terms/extent-of-resection/), [Sentinel node biopsy](https://onco.cc/terms/sentinel-lymph-node-biopsy/)
- people: [Behnam Badie](https://onco.cc/people/behnam-badie/), [Mitchel S. Berger](https://onco.cc/people/mitchel-berger/)
- bottlenecks: [Surgery and radiotherapy cure most, get least](https://onco.cc/bottlenecks/b-surgery-radiation-innovation/)
- ideas: [A pragmatic trial network for intraoperative margin tools, paid on margin reduction](https://onco.cc/ideas/idea-fund-intraoperative-imaging-trials/), [A translation fund for academic surgical devices and radiotherapy technology](https://onco.cc/ideas/idea-fund-device-and-technique-translation-fund/), [An independent evaluation unit for surgical robots and AI, paid on evidence](https://onco.cc/ideas/idea-fund-surgical-ai-robotics-evaluation/), [Real-time margin assessment and image-guided surgery as the global standard](https://onco.cc/ideas/idea-moon-image-guided-surgery-everywhere/)
- drugs: [5-Aminolevulinic acid (oral, for glioma surgery)](https://onco.cc/drugs/aminolevulinic-acid-gleolan/), [Pafolacianine](https://onco.cc/drugs/pafolacianine/), [Pegulicianine](https://onco.cc/drugs/pegulicianine/)
- institutions: [Advanced Research Projects Agency for Health](https://onco.cc/institutions/arpa-h/), [Chang Gung Memorial Hospital](https://onco.cc/institutions/chang-gung-memorial-hospital/), [Chao Family Comprehensive Cancer Center, UC Irvine](https://onco.cc/institutions/uci-chao/), [European Society of Surgical Oncology](https://onco.cc/institutions/esso/), [Purdue Institute for Cancer Research](https://onco.cc/institutions/purdue-cancer-research/), [Society of Surgical Oncology](https://onco.cc/institutions/sso/)
- pathways: [Invasion: proteases, adhesion & the invasive front](https://onco.cc/pathways/invasion-ecm-degradation/)
- roadmaps: [Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes](https://onco.cc/roadmaps/precision-roadmap/), [Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work](https://onco.cc/roadmaps/surgery-roadmap/)

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