Intraoperative Molecular Imaging Combined With Positron Emission Tomography Improves Surgical Management of Peripheral Malignant Pulmonary Nodules

This prospective study evaluated whether intraoperative molecular imaging (IMI) with a folate receptor targeted contrast agent visible in the near-infrared spectrum improved the detection of peripheral malignant lung nodules.  Fifty patients undergoing surgery for peripheral nodules had a preoperative PET scan and were imaged intraoperatively.   IMI identified 95% of nodules and 9 additional lesions not seen preoperatively.  IMI sensitivity was greater than that of PET (96% vs 74%) and had a greater positive predictive value (94% vs 89%).  IMI improved management in 30% of patients.