Fluorescence guided resection (FGR): A primer for oncology

• Fluorescent guided resection (FGR) is a type of Image Guided Surgery.
• FGR in Oncology allows the surgeon better tumor visualization for improved resection.
• FGR as currently practised uses applied fluorescing agents, such as photosensitizers, to image tumor.
• Improved outcomes have been seen with FGR for neurologic and urologic tumors.

Curative treatment for most cancer patients requires surgical removal of the tumor. Often though, residual disease is left behind negatively impacting tumor control and survival. Florescent Guided resection (FGR) is one type of Image Guided Surgery that offers the potential to improve outcomes for these patients. Currently, during FGR, a probe is preoperatively applied and allowed to concentrate in the tumor bed. At surgery appropriate light is applied to generate fluorescence which allows the surgeon to better visualize tumor extent. This improved visualization has translated both into enhanced rates for resection but also diminished rates of morbidity as less normal tissue need be removed to achieve negative margins. This paper will summarize the theory and practise of FGR as currently applied in clinical oncology including select outcomes and limitations of technique and technology.