Table 1.

Nonspecific and tumor-targeted fluorescence agents used during TORS for HNC

Feature	Nonspecific Agent (ICG)	Tumor-Targeted Agents (e.g., Panitumumab-IRDye800CW)
Primary Utility	Perfusion, SLN mapping, and vascular permeability	Margin assessment and occult tumor detection
Specificity	Modest (71.9%) due to diffuse mucosal uptake and inflammation	High; leverages EGFR overexpression for tumor-specific contrast
Sensitivity	High (91.7%) but limited by low TBR in HNSCC	High; intraoperative TBR of ~ 10.7 in phase II cohorts
Firefly Mode	Standard Firefly (preserves grayscale anatomy)	Sensitive Firefly (suppresses background for low signals).
TBR	Average ~ 1.56	Mean intraoperative ~ 10.7
TORS Limitations	Failed to identify gross tumors or positive margins in some series	Lower absolute intensity; highly dependent on imaging geometry