Fluorescent probes in the near-infrared (NIR) range have immense potential to improve observation of positive margins, lymph nodes, and nerves in prostatectomy. Development of fluorescent dyes and mechanisms of cellular uptake paved the way for the current emerging technologies. However, intracellular transport of fluorophores proved to be logistically challenging with respect to intraoperative deployment. Peptide-based probes with high specificity for nerves enabled broader and more rapid labeling. Key features of the ideal probe include selectivity, minimal background noise, safety, and low cost. Human neuropeptide 401 (HNP401) and oxazine-based probes perform well in these categories. As for tumor-specific labeling, prostate specific membrane antigen is relatively selective for the prostate and can be conjugated to a fluorophore. NIR spectrum emission is an ideal range for clinical imaging use, as fluorescence occurs outside the field of visible light, and tissue optical properties diverge significantly at the visible-NIR transition. Indocyanine, carbocyanine, and fluorescein derivatives are common fluorophore conjugates for the probes. Finally, to harness the power of fluorescence intraoperatively, the surgeon must look through a specialized lens. Multiphoton microscopy, optical coherence tomography, and confocal laser endomicroscopy have emerged as frontrunners in this arena. As with any evolving technology, ongoing research is expanding the applications of fluorescent intraoperative imaging in prostate surgery. Innovations in camera technology, dye selection, and image processing are refining the technique's capabilities. A core challenge of these technologies translating into the operating room relates to size and the ability to view objects at vastly different magnifications. Dual modality zoom settings are promising solutions. Furthermore, interdisciplinary collaboration between surgeons, imaging specialists, and researchers continues to drive advancements. In conclusion, fluorescent intraoperative imaging has the potential to usher in a new era of precision and safety in prostate surgery.

中文翻译：

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保留神经的前列腺切除术的术中荧光图像指导：历史背景和当前研究的回顾。

近红外 (NIR) 范围内的荧光探针在改善前列腺切除术中阳性切缘、淋巴结和神经的观察方面具有巨大潜力。荧光染料和细胞摄取机制的发展为当前新兴技术铺平了道路。然而，事实证明，荧光团的细胞内运输在术中部署方面具有后勤方面的挑战。基于肽的探针对神经具有高度特异性，可以实现更广泛、更快速的标记。理想探头的主要特点包括选择性、最小背景噪声、安全性和低成本。人类神经肽 401 (HNP401) 和恶嗪探针在这些类别中表现良好。至于肿瘤特异性标记，前列腺特异性膜抗原对前列腺具有相对选择性，并且可以与荧光团缀合。近红外光谱发射是临床成像使用的理想范围，因为荧光发生在可见光场之外，并且组织光学特性在可见光-近红外过渡处显着发散。吲哚菁、碳菁和荧光素衍生物是探针的常见荧光团缀合物。最后，为了在术中利用荧光的力量，外科医生必须通过专门的镜头进行观察。多光子显微镜、光学相干断层扫描和共焦激光内窥镜已成为该领域的领跑者。与任何不断发展的技术一样，正在进行的研究正在扩大荧光术中成像在前列腺手术中的应用。相机技术、染料选择和图像处理方面的创新正在完善该技术的功能。这些技术应用于手术室的核心挑战涉及尺寸和以截然不同的放大倍率观察物体的能力。双模态变焦设置是有前途的解决方案。此外，外科医生、影像专家和研究人员之间的跨学科合作继续推动进步。总之，术中荧光成像有可能开创前列腺手术精确性和安全性的新时代。