Optical surgical navigation for nodal staging: to see or not to see?

The success of optical surgical navigation depends upon being able to intraoperatively employ a contrast agent and an imaging device to successfully guide surgery. Development of devices and contrast agents typically occur separately even though it is their combined performance that ultimately determines success and clinical adoption. Herein, we review critical issues and summarize our strategies and approaches for validating molecularly-targeted, near-infrared fluorescent contrast agents and the devices sufficiently sensitive enough for their detection in order to guide lymph node dissection.