The development of low profile gamma-ray detectors has encouraged the production of small field of view (SFOV) hand-held imaging devices for use at the patient bedside and in operating theatres. Early development of these SFOV cameras was focussed on a single modality—gamma ray imaging. Recently, a hybrid system—gamma plus optical imaging—has been developed. This combination of optical and gamma cameras enables high spatial resolution multi-modal imaging, giving a superimposed scintigraphic and optical image. Hybrid imaging offers new possibilities for assisting clinicians and surgeons in localising the site of uptake in procedures such as sentinel node detection. The hybrid camera concept can be extended to a multimodal detector design which can offer stereoscopic images, depth estimation of gamma-emitting sources, and simultaneous gamma and fluorescence imaging. Recent improvements to the hybrid camera have been used to produce dual-modality images in both laboratory simulations and in the clinic. Hybrid imaging of a patient who underwent thyroid scintigraphy is reported. In addition, we present data which shows that the hybrid camera concept can be extended to estimate the position and depth of radionuclide distribution within an object and also report the first combined gamma and Near-Infrared (NIR) fluorescence images.
The development of compact low profile gamma-ray detectors has allowed the production of small field of view, hand held imaging devices for use at the patient bedside and in operating theatres. The combination of an optical and a gamma camera, in a co-aligned configuration, offers high spatial resolution multi-modal imaging giving a superimposed scintigraphic and optical image. This innovative introduction of hybrid imaging offers new possibilities for assisting surgeons in localising the site of uptake in procedures such as sentinel node detection. Recent improvements to the camera system along with results of phantom and clinical imaging are reported.
A novel hand-held hybrid optical-gamma camera (HGC) has previously been described that is capable of displaying co-aligned images from both modalities in a single imaging system. Here, a dedicated NIR imaging system for NIR fluorescence surgical guidance has been developed for combination with the HGC . This work has evaluated the performance of two NIR fluorescence imaging systems using phantom studies, various fluorophores and various experimental configurations. The threshold detectable concentration of ICG and 800CW dyes were investigated for both systems. Bespoke lymph node phantoms simulating metastases and tissue-like layers were constructed to evaluate the detection capability. ICG could be detected at a minimum concentration of 1 μM for each camera. The lower thresholds for 800CW were 10−2 and 10−3 μM for the modified and NIR cameras, respectively. Both cameras were unable to detect small-sized targets within a 3 mm depth, but were able to identify larger targets as deep as 7 mm. Further improvements are required to optimise the NIR-fluorescence systems for subsequent combination with the HGC to undertake dual gamma-NIR fluorescence intraoperative imaging.
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