Near-infrared fluorescence imaging of thoracic duct anatomy and function in open surgery and video-assisted thoracic surgery.
Near-infrared fluorescence imaging of thoracic duct anatomy and function in open surgery and video-assisted thoracic surgery.
复制标题
DOI：
10.1016/j.jtcvs.2011.03.004
复制
发表时间：
2011-07
影响因子：
6
通讯作者：
Frangioni, John V.
中科院分区：
文献类型：
--
作者：
Ashitate, Yoshitomo;Tanaka, Eiichi;Stockdale, Alan;Choi, Hak Soo;Frangioni, John V.
胸导管损伤引起的乳糜胸通常难以识别和修复。我们假设，近红外（NIR）荧光灯可以提供敏感，实时，高分辨率的术中成像的胸导管解剖和功能。在16只大鼠（n=16），四个潜在的近红外荧光淋巴示踪剂进行了比较，在信号强度和成像时间：吲哚菁绿色（ICG），羧酸的CW 800，ICG吸附到人血清白蛋白（HSA），和CW 800共价结合到HSA（HSA 800）。在8头接近人类大小的猪中验证了最佳药剂，n = 6通过使用手术辅助切除和探查（FLARE）成像系统的开放手术，n = 2通过使用微创成像系统（m-FLARE）的视频辅助胸腔镜手术（VATS）。淋巴示踪剂注射部位，剂量和时间进行了优化。就信号强度、持续成像时间和临床可翻译性而言，最好的淋巴示踪剂是ICG，它已经被FDA批准用于其他适应症。在猪中，将ICG以≥36 μg/kg的剂量简单皮下注射到小腿中，可在注射后5 min开始进行胸导管成像，注射后持续成像至少60 min，并且信号与背景比≥2。利用该技术，可以直接观察到正常胸导管血流、侧支血流、损伤模型和修复模型。在开放手术和VATS中，近红外荧光灯可以提供敏感、持续、实时的胸导管解剖和功能成像。
Chylothorax resulting from damage to the thoracic duct is often difficult to identify and repair. We hypothesized that near-infrared (NIR) fluorescent light could provide sensitive, real-time, high-resolution intraoperative imaging of thoracic duct anatomy and function. In 16 rats (n=16), four potential NIR fluorescent lymphatic tracers were compared in terms of signal strength and imaging time: indocyanine green (ICG), the carboxylic acid of CW800, ICG adsorbed to human serum albumin (HSA), and CW800 conjugated covalently to HSA (HSA800). The optimal agent was validated in eight pigs approaching the size of humans, n = 6 by open surgery using the Fluorescence-Assisted Resection and Exploration (FLARE) imaging system and n = 2 by video-assisted thoracoscopic surgery (VATS) using the minimally invasive imaging system (m-FLARE). Lymphatic tracer injection site, dose, and timing were optimized. For signal strength, sustained imaging time, and clinical translatability, the best lymphatic tracer was ICG, which is already FDA-approved for other indications. In pigs, a simple subcutaneous injection of ICG into the lower leg, at a dose ≥36 μg/kg, provided thoracic duct imaging with an onset of 5 min after injection, sustained imaging for at least 60 min after injection, and a signal-to-background ratio ≥2. Using this technology, normal thoracic duct flow, collateral flow, injury models, and repair models could all be observed under direct visualization. NIR fluorescent light could provide sensitive, sustained, real-time imaging of thoracic duct anatomy and function during both open surgery and VATS in animal models.
登录
查看更多内容
影响因子：
5.5
作者：
Guermazi, A;Brice, P;Sarfati, E
通讯作者：
Sarfati, E
影响因子：
10.6
作者：
Qureshy, A;Kubota, K;Fukuda, H
通讯作者：
Fukuda, H
影响因子：
4.3
作者：
Noel, AA;Gloviczki, P;Deschamps, C
通讯作者：
Deschamps, C
影响因子：
3.6
作者：
Lee BT;Hutteman M;Gioux S;Stockdale A;Lin SJ;Ngo LH;Frangioni JV
通讯作者：
Frangioni JV
影响因子：
4.6
作者：
Wurnig, PN;Hollaus, PH;Wolf, RK
通讯作者：
Wolf, RK