A novel end-to-end PET imaging platform has been developed to enhance surgical precision in osteosarcoma treatment, a highly aggressive bone cancer primarily affecting children and adolescents. Presented at the Society of Nuclear Medicine and Molecular Imaging 2026 Annual Meeting, this platform can rapidly differentiate tumor tissue from normal tissue and assess surgical margins in real time. The technology utilizes a B7-H3-targeted radiotracer, 68Ga-B7H3-BCH, which has shown superior diagnostic capabilities in preclinical studies. By integrating PET/CT with a near-infrared fluorescent probe, the platform facilitates preoperative staging, real-time navigation during surgery, and postoperative margin verification. Histological evaluations have confirmed its accuracy, with margin assessments completed within 30 minutes. The development of this innovative imaging platform represents a potential paradigm shift in osteosarcoma care, moving towards individualized treatment strategies. While still investigational, early feasibility studies in patients are underway, with further validation and regulatory review required for clinical application.