Hands-free, wireless goggles for near-infrared fluorescence and real-time image-guided surgery.
Hands-free, wireless goggles for near-infrared fluorescence and real-time image-guided surgery.
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DOI：
10.1016/j.surg.2011.02.007
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发表时间：
2011-05
期刊：
影响因子：
3.8
通讯作者：
Achilefu, Samuel
中科院分区：
文献类型：
--
作者：
Liu, Yang;Bauer, Adam Q.;Akers, Walter J.;Sudlow, Gail;Liang, Kexian;Shen, Duanwen;Berezin, Mikhail Y.;Culver, Joseph P.;Achilefu, Samuel
目前的癌症管理面临着几个挑战，包括切除后残留肿瘤的发生，使用放射性材料或高浓度的蓝色染料进行前哨淋巴结（SLN）活检，以及在手术室中使用庞大的系统进行图像引导。为了克服这些限制，我们开发了一种实时术中成像设备，当与近红外（NIR）荧光分子探针结合时，可以帮助识别肿瘤边缘，引导手术切除，映射SLN，并无线传输采集的数据进行远程分析。我们开发了一种新的紧凑、无线、可穿戴和电池供电的设备，允许外科医生进行免提操作。基于CCD的消费级夜视观察器用于开发设备的检测器部分，光源部分由紧凑型前照灯开发。这片被改装以同时提供NIR激发和白色光照明。无线通信是通过将电池供电的微型射频视频发射器集成到系统中来实现的。我们将该器械应用于小鼠模型中的几种类型的肿瘤外科手术，包括SLN标测、荧光引导肿瘤切除和远程专家指导下的手术。与传统的成像仪器不同，该设备直接在其目镜上显示荧光信息。当用于SLN绘图时，即使使用示踪剂水平的NIR荧光染料吲哚菁绿色，SLN的位置也清晰可见。当用于肿瘤切除时，肉眼不可见的肿瘤边缘和小结节很容易可视化。在模拟的即时护理环境中，使用该设备的无线功能在远程引导下成功定位并切除肿瘤。重要的是，该原型系统的总成本（1200美元）明显低于现有的成像仪器。我们的研究结果证明了使用新设备来辅助肿瘤手术切除、映射前哨淋巴结和促进远程医疗的可行性。
Current cancer management faces several challenges, including the occurrence of residual tumor after resection, the use of radioactive materials or high concentrations of blue dyes for sentinel lymph node (SLN) biopsy, and use of bulky systems in surgical suites for image guidance. To overcome these limitations, we developed a real-time intraoperative imaging device that, when combined with near infrared (NIR) fluorescent molecular probes, can aid identification of tumor margins, guide surgical resections, map SLNs, and transfer acquired data wirelessly for remote analysis. We developed a new compact, wireless, wearable, and battery-operated device that allows hands-free operation by surgeons. A CCD-based consumer-grade night vision viewer was used to develop the detector portion of the device and the light source portion was developed from a compact headlamp. This piece was retrofitted to provide both NIR excitation and white light illumination simultaneously. Wireless communication was enabled by integrating a battery-operated miniature radio-frequency video transmitter into the system. We applied the device in several types of oncologic surgical procedures in murine models, including SLN mapping, fluorescence-guided tumor resection, and surgery under remote expert guidance. Unlike conventional imaging instruments, the device directly displays fluorescence information on its eyepiece. When employed in SLN mapping, the locations of SLNs were clearly visualized, even with tracer level dosing of a NIR fluorescent dye, indocyanine green. When utilized in tumor resection, tumor margins and small nodules not visible to the naked eye were readily visualized. In a simulated point-of-care setting, tumors were successfully located and removed under remote guidance using the wireless feature of the device. Importantly, the total cost of this prototype system ($1200) is significantly lower than existing imaging instruments. Our results demonstrate the feasibility of using the new device to aid surgical resection of tumors, map SLNs, and facilitate telemedicine.
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影响因子：
5.7
作者：
Montgomery, LL;Thorne, AC;Borgen, PI
通讯作者：
Borgen, PI
影响因子：
2.5
作者：
Gotoh, Kunihito;Yamada, Terumasa;Imaoka, Shingi
通讯作者：
Imaoka, Shingi
影响因子：
82.9
作者：
Bremer, C;Tung, CH;Weissleder, R
通讯作者：
Weissleder, R
影响因子：
45.3
作者：
Vicini, FA;Kestin, LL;Martinez, AA
通讯作者：
Martinez, AA
影响因子：
--
作者：
de Miranda Marzullo, Ana Carolina;Neto, Osmar Pinto;Martin, Airton Abrahao
通讯作者：
Martin, Airton Abrahao