van Keulen S, Nishio N, Fakurnejad S, et al. - Given the consideration of surgical resection using primarily visual and tactile feedback as the gold standard for solid tumors in head and neck cancer and that high numbers of tumor-involved surgical margins are directly correlated to poor clinical outcomes, researchers explored the clinical application of in situ surgical imaging, via reporting on the imaging data that are directly (ie in real-time) accessible to the surgeon. They ascertained fluorescence intensities and tumor-to-background ratios (TBRs) from the intraoperative imaging data–the view as seen by the surgeon during tumor resection–of 20 patients, and correlated these to patient and tumor characteristics including age, gender, tumor site, tumor size, histologic differentiation, and epidermal growth factor receptor expression. In addition, they evaluated different lighting conditions in regard to surgical workflow. Intraoperative TBRs of the primary tumors averaged 2.2 ± 0.4 (range 1.5 to 2.9) under these circumstances. Besides the optimal conditions with respect to both molecular image acquisition and surgical workflow, they presented the results of successful in situ intraoperative imaging of primary tumors. Outcomes suggest that open-field molecular imaging could assist the surgeon in attaining successful cancer removal.