First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows
First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows
复制标题
首次在可见光和近红外 I/II 窗口中进行多光谱荧光成像引导的人类肝脏肿瘤手术
DOI：
10.1038/s41551-019-0494-0
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发表时间：
2019-12-23
影响因子：
28.1
通讯作者：
Tian, Jie
中科院分区：
文献类型：
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作者：
Hu, Zhenhua;Fang, Cheng;Tian, Jie
第二个近红外波长窗口（NIR-II，1，000 - 1，700 nm）能够在毫米深度和微米级分辨率下以增强的对比度对组织进行荧光成像。然而，临床上可行的NIR-II设备的缺乏阻碍了NIR-II成像的临床转化。在这里，我们描述了一种光学成像仪器，它集成了可见光多光谱成像系统与近红外-II和近红外-I（700-900 nm波长）荧光检测（通过使用染料吲哚菁绿色），以帮助23例患者的原发性和转移性肝脏肿瘤的荧光引导手术切除。我们发现，与NIR-I成像相比，术中NIR-II成像提供了更高的肿瘤检测灵敏度（100%对90.6%; 95%置信区间分别为89.1%-100%和75.0%-98.0%），肿瘤与正常肝组织的信号比（5.33比1.45）和肿瘤检出率（56.41%比46.15%）更高。我们推断，结合NIR-I/II光谱窗口和合适的荧光探针可能会提高图像引导手术在clinic.A光学成像仪器，集成了可见光多光谱成像系统与近红外荧光检测在第一和第二窗口援助的荧光引导手术切除肝肿瘤的患者。
The second near-infrared wavelength window (NIR-II, 1,000-1,700 nm) enables fluorescence imaging of tissue with enhanced contrast at depths of millimetres and at micrometre-scale resolution. However, the lack of clinically viable NIR-II equipment has hindered the clinical translation of NIR-II imaging. Here, we describe an optical-imaging instrument that integrates a visible multispectral imaging system with the detection of NIR-II and NIR-I (700-900 nm in wavelength) fluorescence (by using the dye indocyanine green) for aiding the fluorescence-guided surgical resection of primary and metastatic liver tumours in 23 patients. We found that, compared with NIR-I imaging, intraoperative NIR-II imaging provided a higher tumour-detection sensitivity (100% versus 90.6%; with 95% confidence intervals of 89.1%-100% and 75.0%-98.0%, respectively), a higher tumour-to-normal-liver-tissue signal ratio (5.33 versus 1.45) and an enhanced tumour-detection rate (56.41% versus 46.15%). We infer that combining the NIR-I/II spectral windows and suitable fluorescence probes might improve image-guided surgery in the clinic.An optical-imaging instrument that integrates a visible multispectral imaging system with the detection of near-infrared fluorescence in the first and second windows aids the fluorescence-guided surgical resection of liver tumours in patients.