Beyond diagnosis: how advanced imaging technologies are shaping modern surgery

Abstract

Traditional imaging techniques are limited by their preoperative nature, limited image resolution, and the need for radiologist interpretation. Multiple advanced imaging technologies have been developed, which may enhance surgical precision and patient outcomes.

Near-infrared fluorescence (NIRF) imaging, particularly with indocyanine green (ICG) dye, enables perfusion assessments and may help prevent anastomotic leaks. Additionally, NIRF can augment the identification of tumour growth patterns and lymphatic networks, thereby improving resection margin accuracy. Combining NIRF with radioisotope tracers allows for deep tissue navigation with high-precision dissection. In advanced disease, radioisotope scans may also enable prompt identification and excision of distally affected lymph nodes. Hyperspectral imaging (HSI) provides molecular-level information without the need for harmful contrast agents. HSI tissue vascularisation data may help shorten procedure times and reduce perioperative morbidity. Furthermore, when combined with neural networks, the technology can improve tumour detection and tissue differentiation.

Extended reality (XR) has multiple applications within surgical imaging. Augmented reality (AR) allows for intraoperative image overlays, thereby improving surgical navigation. Additionally, virtual reality (VR) may help users to visualise three-dimensional anatomical reconstructions, with applications in surgical training and patient consent. Artificial intelligence (AI) systems offer enhanced perioperative information to surgeons, such as the prediction of both disease progression and patient response to treatment. These benefits are compounded when paired with imaging modalities, such as HSI and XR.

Overall, advanced imaging technologies offer an exciting future for surgical practice and improved patient outcomes. Further work, including standardised protocols and ethical frameworks, is required.

Keywords

Imaging / extended reality / hyperspectral / fluorescence / artificial intelligence / surgery

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