Surreal illustration of dual-modality imaging in ovarian cancer surgery.

Ovarian Cancer Detection: The Future is Clear(ly Fluorescent)

Elliot Brynn in Health & Wellness August 2025 • 4 min read.

"Dual-modality imaging offers a new hope for improved intraoperative detection and complete resection of ovarian cancer."

Ovarian cancer, often called the 'silent killer,' is frequently diagnosed at advanced stages because its symptoms appear late. This unfortunate reality means that about 70% of patients already have the disease spreading within or beyond the pelvis when they are first diagnosed. The key to improving survival rates lies in the complete removal of tumor lesions during surgery.

Surgery is a cornerstone treatment, involving either primary debulking or neoadjuvant chemotherapy followed by interval debulking. Regardless of the approach, the extent of residual disease left after surgery is a critical factor affecting how long a patient lives without the cancer progressing. The challenge? It's often difficult to distinguish between cancerous and benign tissue, especially after chemotherapy, where tumors may shrink or disappear visually.

To combat this, researchers are exploring innovative imaging techniques that can be used during surgery to highlight tumor-specific characteristics. One promising avenue involves targeting the folate receptor alpha (FRa), which is highly expressed in approximately 90% of ovarian carcinomas, while showing limited presence in normal tissues. This makes FRa an ideal marker for targeted therapies and imaging.

Dual-Modality Imaging: A Clearer Picture of Ovarian Cancer

Surreal illustration of dual-modality imaging in ovarian cancer surgery.

A recent study published in Molecular Pharmaceutics explores the feasibility of using a dual-modality imaging approach to improve intraoperative detection of ovarian cancer. This method combines the strengths of two different imaging techniques: radioactive and fluorescent. The researchers used farletuzumab, a humanized antibody that specifically recognizes FRa, labeled with both a radioactive isotope (Indium-111) and a fluorescent dye (IRDye800CW).

This dual-labeled antibody, 111In-farletuzumab-IRDye800CW, allows surgeons to visualize ovarian cancer lesions in real-time during surgery. The radioactive component can detect deeply located tumors, while the fluorescent label provides precise delineation of superficial tumors. This combination offers a comprehensive approach to identifying and removing all cancerous tissue.

Enhanced Detection: Dual-modality imaging significantly improves the detection of ovarian cancer lesions, even those that are small or deeply located.
Real-Time Guidance: Surgeons can use the fluorescent label to guide the resection of superficial tumors with greater precision.
Reduced False Positives: By targeting FRa, the imaging technique minimizes the risk of false positives, ensuring that only cancerous tissue is removed.
Improved Outcomes: Complete resection of tumor lesions leads to better survival rates and a higher quality of life for patients.

The study demonstrated that multiple intra-abdominal tumor lesions could be clearly visualized using microSPECT/CT, while fluorescence imaging helped guide the resection of superficial tumors. Co-injection of an excess of unlabeled farletuzumab significantly decreased tumor uptake, confirming that the dual-labeled antibody was specifically targeting FRa.

Looking Ahead: The Future of Ovarian Cancer Surgery

This research paves the way for more effective and precise ovarian cancer surgery. By combining radioactive and fluorescent imaging techniques, surgeons can now visualize and remove tumor lesions with greater accuracy, potentially leading to improved outcomes for patients.

The next step is to evaluate the clinical value of dual-modality imaging and fluorescence-guided surgery in advanced-stage ovarian cancer patients. Clinical trials are needed to determine whether this approach can improve survival rates and reduce the risk of recurrence.

As imaging technologies continue to advance, the future of ovarian cancer surgery looks brighter. Dual-modality imaging offers a new hope for complete tumor resection and a better quality of life for women battling this challenging disease.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1021/acs.molpharmaceut.7b00464, Alternate LINK

Title: Improved Intraoperative Detection Of Ovarian Cancer By Folate Receptor Alpha Targeted Dual-Modality Imaging

Subject: Drug Discovery

Journal: Molecular Pharmaceutics

Publisher: American Chemical Society (ACS)

Authors: Marlène C. H. Hekman, Otto C. Boerman, Desirée L. Bos, Leon F. A. G. Massuger, Susan Weil, Luigi Grasso, Katherine A. Rybinski, Egbert Oosterwijk, Peter F. A. Mulders, Mark Rijpkema

Published: 2017-08-30

Everything You Need To Know

Why is ovarian cancer often diagnosed at advanced stages, and what role does surgery play in treatment?

Ovarian cancer is frequently diagnosed late because its symptoms appear late, leading to the spread of the disease. Surgery, involving primary debulking or neoadjuvant chemotherapy followed by interval debulking, is a critical treatment. The extent of residual disease post-surgery significantly impacts patient survival. New imaging techniques are being explored to better distinguish between cancerous and benign tissue, especially after chemotherapy-induced tumor shrinkage.

How does dual-modality imaging enhance the precision of ovarian cancer surgery?

Dual-modality imaging combines radioactive and fluorescent tracers to improve intraoperative detection of ovarian cancer. By using a dual-labeled antibody, 111In-farletuzumab-IRDye800CW, surgeons can visualize ovarian cancer lesions in real-time. The radioactive component detects deeply located tumors, while the fluorescent label provides precise delineation of superficial tumors. This combination allows for a more comprehensive identification and removal of cancerous tissue.

What is folate receptor alpha (FRa), and why is it a target for ovarian cancer imaging and therapies?

Folate receptor alpha (FRa) is highly expressed in approximately 90% of ovarian carcinomas, while showing limited presence in normal tissues, making it an ideal marker for targeted therapies and imaging. The dual-labeled antibody, 111In-farletuzumab-IRDye800CW, specifically targets FRa, allowing surgeons to visualize and remove tumor lesions with greater accuracy during surgery.

What are the key benefits of using dual-modality imaging in ovarian cancer surgery, and how do these benefits contribute to improved patient outcomes?

The benefits of dual-modality imaging include enhanced detection of both small and deeply located ovarian cancer lesions, real-time guidance for surgeons during resection of superficial tumors, and reduced false positives by specifically targeting FRa. Complete resection of tumor lesions leads to better survival rates and improved quality of life for patients. By combining radioactive and fluorescent imaging techniques, surgeons can visualize and remove tumor lesions with greater accuracy.

How was the effectiveness of the dual-modality imaging approach confirmed in the study, and what are the future implications for ovarian cancer surgery?

The effectiveness of the dual-modality imaging approach was confirmed by clearly visualizing multiple intra-abdominal tumor lesions using microSPECT/CT, while fluorescence imaging helped guide the resection of superficial tumors. Co-injection of an excess of unlabeled farletuzumab significantly decreased tumor uptake, confirming that the dual-labeled antibody was specifically targeting FRa. This research paves the way for more effective and precise ovarian cancer surgery, potentially leading to improved outcomes for patients through better visualization and removal of tumor lesions.