{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:00:22Z","timestamp":1791968422407,"version":"4.3.4"},"reference-count":108,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","award":["SGL027\/1011"],"award-info":[{"award-number":["SGL027\/1011"]}],"id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","award":["#10666"],"award-info":[{"award-number":["#10666"]}],"id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","award":["#Z20H160031"],"award-info":[{"award-number":["#Z20H160031"]}],"id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Dutch Cancer Foundation","award":["SGL027\/1011"],"award-info":[{"award-number":["SGL027\/1011"]}]},{"name":"Dutch Cancer Foundation","award":["#10666"],"award-info":[{"award-number":["#10666"]}]},{"name":"Dutch Cancer Foundation","award":["#Z20H160031"],"award-info":[{"award-number":["#Z20H160031"]}]},{"name":"Zhejiang Provincial Foreign Expert Program Grant","award":["SGL027\/1011"],"award-info":[{"award-number":["SGL027\/1011"]}]},{"name":"Zhejiang Provincial Foreign Expert Program Grant","award":["#10666"],"award-info":[{"award-number":["#10666"]}]},{"name":"Zhejiang Provincial Foreign Expert Program Grant","award":["#Z20H160031"],"award-info":[{"award-number":["#Z20H160031"]}]},{"name":"Jiaxing city government","award":["SGL027\/1011"],"award-info":[{"award-number":["SGL027\/1011"]}]},{"name":"Jiaxing city government","award":["#10666"],"award-info":[{"award-number":["#10666"]}]},{"name":"Jiaxing city government","award":["#Z20H160031"],"award-info":[{"award-number":["#Z20H160031"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Surgical resection for pancreatic ductal adenocarcinoma (PDAC) entails the excision of the primary tumour and regional lymphadenectomy. This traditional strategy is challenged by the high rate of early recurrence, suggesting inadequate disease staging. Novel methods of intra-operative staging are needed to allow surgical resection to be tailored to the disease\u2019s biology. Methods: A search of published articles on the PubMed and Embase databases was performed using the terms \u2018pancreas\u2019 OR \u2018pancreatic\u2019 AND \u2018intra-operative staging\/detection\u2019 OR \u2018guided surgery\u2019. Articles published between January 2000 and June 2023 were included. Technologies that offered intra-operative staging and tailored treatment were curated and summarised in the following integrative review. Results: lymph node (LN) mapping and radioimmunoguided surgery have shown promising results but lacked practicality to facilitate real-time intra-operative staging for PDAC. Fluorescence-guided surgery (FGS) offers high contrast and sensitivity, enabling the identification of cancerous tissue and positive LNs with improved precision following intravenous administration of a fluorescent agent. The unique properties of optical coherence tomography and ultrasound elastography lend themselves to be platforms for virtual biopsy intra-operatively. Conclusions: Accurate intra-operative staging of PDAC, localisation of metastatic LNs, and identification of extra-pancreatic disease remain clinically unmet needs under current detection methods and staging standards. Tumour-specific FGS combined with other diagnostic and therapeutic modalities could improve tumour detection and staging in patients with PDAC.<\/jats:p>","DOI":"10.3390\/cancers16223803","type":"journal-article","created":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T05:21:59Z","timestamp":1731388919000},"page":"3803","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Intra-Operative Tumour Detection and Staging in Pancreatic Cancer Surgery: An Integrative Review of Current Standards and Future Directions"],"prefix":"10.3390","volume":"16","author":[{"given":"Ahmed","family":"Kotb","sequence":"first","affiliation":[{"name":"Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1952-5699","authenticated-orcid":false,"given":"Zaynab","family":"Hafeji","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadel","family":"Jesry","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1236-5599","authenticated-orcid":false,"given":"Nicole","family":"Lintern","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Pathak","sequence":"additional","affiliation":[{"name":"The Pancreato-Biliary Unit, St James\u2019s University Teaching Hospital, Leeds LS9 7TF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3854-8525","authenticated-orcid":false,"given":"Andrew M.","family":"Smith","sequence":"additional","affiliation":[{"name":"The Pancreato-Biliary Unit, St James\u2019s University Teaching Hospital, Leeds LS9 7TF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9387-9140","authenticated-orcid":false,"given":"Kishan R. D.","family":"Lutchman","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands"},{"name":"Department of Biomedical Engineering and Physics, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"de Bruin","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering and Physics, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3284-7276","authenticated-orcid":false,"given":"Rob","family":"Hurks","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0630-4465","authenticated-orcid":false,"given":"Michal","family":"Heger","sequence":"additional","affiliation":[{"name":"Jiaxing Key Laboratory for Photonanomedicine and Experimental Therapeutics, Department of Pharmaceutics, College of Medicine, Jiaxing University, Jiaxing 314001, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yazan S.","family":"Khaled","sequence":"additional","affiliation":[{"name":"Leeds Institute of Medical Research, University of Leeds, Leeds LS2 9JT, UK"},{"name":"The Pancreato-Biliary Unit, St James\u2019s University Teaching Hospital, Leeds LS9 7TF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21551","article-title":"Cancer statistics, 2019","volume":"69","author":"Siegel","year":"2019","journal-title":"CA Cancer J. 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