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Abstract
Over 300 million surgeries are performed worldwide each year. The ultimate goal of surgery is to repair damage or remove diseased tissues, while minimizing comorbidities by preserving vital structures such as nerves and blood vessels. However, surgeons still rely mainly on the basic tools of naked eye visualization and palpation for guidance during surgery, leaving incomplete resection rates high and comorbidities like nerve damage as a major problem. Fluorescence-guided surgery (FGS) has the potential to revolutionize surgery by enhancing visualization of specific tissues intraoperatively. Using optical imaging of targeted fluorescent probes, FGS offers sensitive, real-time, wide-field imaging using compact imaging systems that are easily integrated into the operating room. Several imaging systems are clinically available for FGS applications, however only a handful of contrast agents have been approved. Numerous preclinical studies for new agents have shown promise for improved surgical outcomes such as tumor resection or nerve-sparing. However, as non-curative diagnostic agents these new probes must overcome an enormous regulatory challenge to achieve clinical translation. The work presented herein has been carried out to develop novel targeted contrast agents for tumor margin detection and nerve identification as well as create more clinically viable administration methods to aid in their clinical translation.