Delineating the tumor margin with intraoperative surface-enhanced Raman spectroscopy

The failure of complete tumor resection during cancer surgery is a leading cause of lethal recurrence and metastasis. However, achieving accurate delineation of tumor margins intraoperatively remains extremely difficult because the infiltrated nature of a tumor usually gives an obscure margin and spreading microtumors. Recent studies show that surface-enhanced Raman scattering (SERS) has the potential to depict precisely the actual tumor extent with high sensitivity, specificity, and spatial resolution; thus providing a promising platform to improve the therapeutic efficiency. In this review, we discuss the recent progress in the use of SERS spectroscopy for intraoperative image-guided resection. We highlight key successes in the development of SERS tags and give insights into the design mechanism of rational SERS tags. We also discuss how to improve the performance of intraoperative navigation based on SERS and explore the challenges and future opportunities for the development of a more effective SERS-based platform.