Strategies for Curative Fluorescence-Guided Surgery of Cancer

Strategies for Curative Fluorescence-Guided Surgery of Cancer
Author: Robert Hoffman
Publisher: Academic Press
Total Pages: 296
Release: 2020-05-27
Genre: Medical
ISBN: 0128126779

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Strategies for Curative Fluorescence-Guided Surgery of Cancer is the first book to discuss how fluorescence-guided surgery can be successfully used during surgeries with several tumor types. FGS is one of the most exciting emerging modalities of surgery, especially cancer surgery, as it potentially allows the surgeon to visualize the actual margin of the tumor, thus greatly increasing the possibility of curative resection. The book discusses the applicability of FGS for several types of cancer, such as pancreatic cancer, liver metastasis, soft-tissue sarcoma, glioma, melanoma, and breast and lung cancer. This book is a valuable resource for cancer surgeons, cancer researchers and members of several other areas in the biomedical field who are interested in understanding this powerful technique. Presents an overview of fluorescence-guided surgery Explains general strategies for curative fluorescence-guided surgery and their applicability for each major tumor type Discusses the current and future achievements of FGS as a precise technique for cancer surgeries

Dynamic Fluorescence Imaging with Molecular Agents for Cancer Detection

Dynamic Fluorescence Imaging with Molecular Agents for Cancer Detection
Author: Sun Kuk Kwon
Publisher:
Total Pages:
Release: 2010
Genre:
ISBN:

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Non-invasive dynamic optical imaging of small animals requires the development of a novel fluorescence imaging modality. Herein, fluorescence imaging is demonstrated with sub-second camera integration times using agents specifically targeted to disease markers, enabling rapid detection of cancerous regions. The continuous-wave fluorescence imaging acquires data with an intensified or an electronmultiplying charge-coupled device. The work presented in this dissertation (i) assessed dose-dependent uptake using dynamic fluorescence imaging and pharmacokinetic (PK) models, (ii) evaluated disease marker availability in two different xenograft tumors, (iii) compared the impact of autofluorescence in fluorescence imaging of near-infrared (NIR) vs. red light excitable fluorescent contrast agents, (iv) demonstrated dual-wavelength fluorescence imaging of angiogenic vessels and lymphatics associated with a xenograft tumor model, and (v) examined dynamic multi-wavelength, whole-body fluorescence imaging with two different fluorescent contrast agents. PK analysis showed that the uptake of Cy5.5-c(KRGDf) in xenograft tumor regions linearly increased with doses of Cy5.5-c(KRGDf) up to 1.5 nmol/mouse. Above 1.5 nmol/mouse, the uptake did not increase with doses, suggesting receptor saturation. Target to background ratio (TBR) and PK analysis for two different tumor cell lines showed that while Kaposi's sarcoma (KS1767) exhibited early and rapid uptake of Cy5.5-c(KRGDf), human melanoma tumors (M21) had non-significant TBR differences and early uptake rates similar to the contralateral normal tissue regions. The differences may be due to different compartment location of the target. A comparison of fluorescence imaging with NIR vs. red light excitable fluorescent dyes demonstrates that NIR dyes are associated with less background signal, enabling rapid tumor detection. In contrast, animals injected with red light excitable fluorescent dyes showed high autofluorescence. Dual-wavelength fluorescence images were acquired using a targeted 111In- DTPA-K(IRDye800)-c(KRGDf) to selectively detect tumor angiogenesis and an untargeted Cy5.5 to image lymphatics. After acquiring the experimental data, fluorescence image-guided surgery was performed. Dynamic, multi-wavelength fluorescence imaging was accomplished using a liquid crystal tunable filter (LCTF). Excitation light was used for reflectance images with a LCTF transmitting a shorter wavelength than the peak in the excitation light spectrum. Therefore, images can be dynamically acquired alternating frame by frame between emission and excitation light, which should enable image-guided surgery.

Fluorescence-Guided Surgery

Fluorescence-Guided Surgery
Author: Takeaki Ishizawa
Publisher: Springer Nature
Total Pages: 254
Release: 2023-12-05
Genre: Medical
ISBN: 9811973725

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This volume is a practical guide of theranostics using intraoperative fluorescence imaging technology, as an all-out effort by the Japanese Society for Fluorescence Guided Surgery. It describes the various approaches the technique is being used such as vascular imaging, identification of lymphatic vessels by intratissue injection, lymph node imaging, and imaging for identification of anatomical structures. The book is organized into three major parts and the first one delivers the basics, introducing the use of the technology in clinical settings and initial setups. Next comes the description of clinical applications where chapters illustrate perfusion assessment, cancer localization, anatomy visualization, and lymph nodes/ducts mapping. Each chapter is devoted to the specific surgical field and disease areas, presenting images and videos of case studies. The last part presents some upcoming techniques for treatments. The Editor and the authors wish the ideas presented here will be hints to bridge the knowledge between surgeons and basic researchers for further innovation and practicality. It is important to stay up-to-date since intraoperative fluorescence imaging has been applied to clinical settings in various surgical fields and at the same time, novel techniques improving the efficacy of the technology have also been developed actively. Fluorescence-Guided Surgery – From Lab to Operation Room is recommended for surgeons, operating nurses, medical experts, basic researchers and, industry engineers worldwide beyond boundaries of specialties. Edited and written by experts of The Japanese Society for Fluorescence-Guided Surgery, those who are the founders of the technology, it describes the accurate development history and cutting-edge techniques based on the knowledge accumulated over the years. ​

The SAGES Manual of Fluorescence-Guided Surgery

The SAGES Manual of Fluorescence-Guided Surgery
Author: Nova Szoka
Publisher: Springer Nature
Total Pages: 515
Release: 2023-11-27
Genre: Medical
ISBN: 3031406850

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Fluorescence-guided surgery (FGS) is defined as a medical imaging technique that uses a fluorescent dye or a near-infrared emitting light source to identify anatomic structures during surgical procedures. In 2020 alone, over 1200 academic articles were published on the topic of fluorescence-guidance surgery, a sign that this modality is making significant inroads into surgical practice. The use of near-infrared imaging and FGS is a rapidly growing modality, allowing surgeons to see more intraoperatively, enhance surgical precision, and improve surgical decision-making and patient outcomes. This manual provides a comprehensive, state-of-the art review of this field and will serve as a valuable resource for clinicians, surgeons and researchers with an interest in fluorescence-guided surgery, guiding patient management and stimulating investigative efforts. After initial chapters discussing the history of FGS and the current platforms and devices, it presents the most up-to-date data regarding the use of FGS in multiple surgical fields - colorectal, hepatic, endocrine, reconstructive, pediatric, among others - as well as in the treatment of specific conditions such as burns. Chapters are generously illustrated with full-color figures and intraoperative photographs, and selected chapters include video segments. Access to a comprehensive resource such as this is currently limited by the relatively new inroads that fluorescence-guided technology has made into surgery. The SAGES Manual of Fluorescence-Guided Surgery fills this gap in the literature.

Bio-inspired Multi-spectral Image Sensor and Augmented Reality Display for Near-infrared Fluorescence Image-guided Surgery

Bio-inspired Multi-spectral Image Sensor and Augmented Reality Display for Near-infrared Fluorescence Image-guided Surgery
Author: Nan Cui
Publisher:
Total Pages: 101
Release: 2018
Genre: Electronic dissertations
ISBN:

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Background: Cancer remains a major public health problem worldwide and poses a huge economic burden. Near-infrared (NIR) fluorescence image-guided surgery (IGS) utilizes molecular markers and imaging instruments to identify and locate tumors during surgical resection. Unfortunately, current state-of-the-art NIR fluorescence imaging systems are bulky, costly, and lack both fluorescence sensitivity under surgical illumination and co-registration accuracy between multimodal images. Additionally, the monitor-based display units are disruptive to the surgical workflow and are suboptimal at indicating the 3-dimensional position of labeled tumors. These major obstacles have prevented the wide acceptance of NIR fluorescence imaging as the standard of care for cancer surgery. The goal of this dissertation is to enhance cancer treatment by developing novel image sensors and presenting the information using holographic augmented reality (AR) display to the physician in intraoperative settings.Method: By mimicking the visual system of the Morpho butterfly, several single-chip, color-NIR fluorescence image sensors and systems were developed with CMOS technologies and pixelated interference filters. Using a holographic AR goggle platform, an NIR fluorescence IGS display system was developed. Optoelectronic evaluation was performed on the prototypes to evaluate the performance of each component, and small animal models and large animal models were used to verify the overall effectiveness of the integrated systems at cancer detection.Result: The single-chip bio-inspired multispectral logarithmic image sensor I developed has better main performance indicators than the state-of-the-art NIR fluorescence imaging instruments. The image sensors achieve up to 140 dB dynamic range. The sensitivity under surgical illumination achieves 6 x 108 [mu]V/(mW/cm2), which is up to 25 times higher. The signal-to-noise ratio is up to 56 dB, which is 11 dB greater. These enable high sensitivity fluorescence imaging under surgical illumination. The pixelated interference filters enable temperature-independent co-registration accuracy between multimodal images. Pre-clinical trials with small animal model demonstrate that the sensor can achieve up to 95% sensitivity and 94% specificity with tumor-targeted NIR molecular probes. The holographic AR goggle provides the physician with a non-disruptive 3-dimensional display in the clinical setup. This is the first display system that co-registers a virtual image with human eyes and allows video rate image transmission. The imaging system is tested in the veterinary science operating room on canine patients with naturally occurring cancers. In addition, a time domain pulse-width-modulation address-event-representation multispectral image sensor and a handheld multispectral camera prototype are developed.Conclusion: The major problems of current state-of-the-art NIR fluorescence imaging systems are successfully solved. Due to enhanced performance and user experience, the bio-inspired sensors and augmented reality display system will give medical care providers much needed technology to enable more accurate value-based healthcare.