Intraoperative probes and imaging probes

Intraoperative probes have been employed to assist in the detection and rem oval of tumors for more than 50 years, For a period of about 40 years, esse ntially every detector type that could be miniaturized had been tested or a t least suggested for use as an intraoperative probe. These detectors inclu ded basic Geiger-Muller (GM) tubes, scintillation detectors, and even state -of-the - art solid state detectors. The radiopharmaceuticals have progress ed from (PO4)-P-32- injections for brain tumors to sophisticated monoclonal antibodies labeled with iodine-125 for colorectal cancers. The early work was mostly anecdotal, primarily interdisciplinary collaborations between su rgeons and physical scientists. These collaborations produced a few publica tions, but never seemed to result in an ongoing clinical practice. In the m id 1980s, several companies offered basic gamma-detecting intraoperative pr obes as products. This led to the rapid development of radioimmunoguided su rgery (RIGS) and sentinel node detection as regularly practiced procedures to assist in the diagnosis and treatment of cancer. In recent years intraop erative imaging probes have been developed. These devices add the ability t o see the details of the detected activity, giving the potential of using t he technique in a low-contrast environment. Intraoperative probes are now e stablished as clinical devices, they have a commercial infrastructure to su pport their continued use, and there is ongoing research, both commercial a nd academic, that would seem to ensure continued progress and renewed inter est in this slowly developing field.