Evaluation of Dynamic Optical Projection of Acquired Luminescence for Sentinel Lymph Node Biopsy in Large Animals.
Evaluation of Dynamic Optical Projection of Acquired Luminescence for Sentinel Lymph Node Biopsy in Large Animals.
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DOI：
10.1177/1533034615604978
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发表时间：
2016-12
影响因子：
2.8
通讯作者：
Akers WJ
中科院分区：
文献类型：
--
作者：
Ringhausen E;Wang T;Pitts J;Sarder P;Akers WJ
需要细胞减灭术的开放手术仍然是许多癌症的主要治疗过程。切除范围对手术结果至关重要，极大地影响患者的后续治疗，包括在切缘阳性的情况下是否需要翻修手术，化疗的选择和总生存率。现有的成像模式，如CT、MRI和PET，在诊断阶段和长期监测中是有用的，但不能提供术中手术指导所需的时间或空间分辨率水平。外科医生必须依靠视觉评估和触诊来区分肿瘤和周围组织。荧光成像通过使用造影剂提供高分辨率、实时标测，并可大大增强术中成像。在这里，我们展示了一种术中实时荧光成像系统，用于直接突出显示靶组织，用于手术指导，获得的发光（OPAL）的光学投影。在证明在前哨淋巴结活检的大型动物模型中用于手术室（OR）的可行性之前，在体外确定图像对准、准确度和分辨率。在OPAL系统的手术引导下，皮内注射吲哚菁绿色（ICG）后，对猪的局部淋巴结进行荧光识别。对采集的荧光图像进行处理并快速重新投影，以突出显示真实手术野内的ICG。OPAL增强了淋巴结切除的可视化。结果表明，OPAL系统可以成功地使用荧光图像捕获和投影来提供在OR设置中人眼不可见的对齐图像数据。
Open surgery requiring cytoreduction still remains the primary treatment course for many cancers. The extent of resection is vital for the outcome of surgery, greatly affecting patients’ follow-up treatment including need for revision surgery in the case of positive margins, choice of chemotherapy and overall survival. Existing imaging modalities such as CT, MRI, and PET are useful in the diagnostic stage and long-term monitoring, but do not provide the level of temporal or spatial resolution needed for intraoperative surgical guidance. Surgeons must instead rely on visual evaluation and palpation in order to distinguish tumors from surrounding tissues. Fluorescence imaging provides high resolution, real-time mapping with the use of a contrast agent and can greatly enhance intraoperative imaging. Here we demonstrate an intraoperative, real-time fluorescence imaging system for direct highlighting of target tissues for surgical guidance, optical projection of acquired luminescence (OPAL). Image alignment, accuracy, and resolution was determined in vitro prior to demonstration of feasibility for operating room (OR) use in large animal models of sentinel lymph node biopsy. Fluorescence identification of regional lymph nodes after intradermal injection of indocyanine green (ICG) was performed in pigs with surgical guidance from the OPAL system. Acquired fluorescence images were processed and rapidly re-projected to highlight ICG within the true surgical field. OPAL produced enhanced visualization for resection of lymph nodes. Results show the OPAL system can successfully use fluorescence image capture and projection to provide aligned image data that is invisible to the human eye in the OR setting.