First-in-human evaluation of a hybrid modality that allows combined radio- and (near-infrared) fluorescence tracing during surgery

Berg, Nynke S. van den; Simon, H.; KleinJan, G.H.; Engelen, Thijs; Bunschoten, Anton; Welling, Mick M.; Tijink, Bernard M.; Horenblas, Simon; Chambron, J.; Leeuwen, Fijs W. B. van

doi:10.1007/s00259-015-3109-3

Cited by 48 publications

(32 citation statements)

References 17 publications

(20 reference statements)

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“…This can, in part, be realized using a hybrid tracer that contains 2 distinct signals, for example, the sentinel node (SN) tracer indocyanine green (ICG)-99m Tc-nanocolloid (1). Recently, this hybrid concept was expanded beyond the field of tracer development to hardware-based integration of radioguidance and FI modalities (4,5).…”

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confidence: 99%

Toward (Hybrid) Navigation of a Fluorescence Camera in an Open Surgery Setting

et al. 2016

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With the introduction of the hybrid tracer indocyanine green (ICG)-99m Tc-nanocolloid, a direct relation between preoperative imaging and intraoperative fluorescence guidance was established. However, fluorescence guidance remains limited by its superficial nature. This study evaluated the feasibility of a nuclear medicinebased navigation concept that allowed intraoperative positioning of a fluorescence camera (FC) in the vicinity of preoperatively defined ICG-99m Tc-nanocolloid containing sentinel nodes (SNs). Methods: Five patients with penile cancer scheduled for SN biopsy were injected with ICG-99m Tc-nanocolloid followed by preoperative SPECT/CT imaging. The navigation device was used to provide a real-time augmented reality overlay of the SPECT/CT images and video output of the FC. This overlay was then used for FC navigation.

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confidence: 99%

Toward (Hybrid) Navigation of a Fluorescence Camera in an Open Surgery Setting

et al. 2016

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“…Further gains in accuracy may be achieved by combining the ICG with another tracing method, as dual-tracer techniques have shown increased accuracy over single-tracer methods in breast cancer and melanoma [39, 40]. Academic units are exploring combined use of radioguidance and NIR (using technetium-99m-labelled nanocolloid bound to ICG) to increase the accuracy on SLNM in head and neck, and urogenital cancer [41] and trials in the Netherlands are currently investigating this approach in colonic malignancy. Furthermore, the addition of single-photon emission computed tomography has been proposed to aid preoperative localisation of SLNs in various cancers [42] and this may improve accuracy when using minimally invasive surgery for early colonic malignancy.…”

Section: Resultsmentioning

confidence: 99%

Intraoperative Sentinel Node Mapping in the Colon: Potential and Pitfalls

Currie¹

2019

Eur Surg Res

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Sentinel lymph node mapping (SLNM) may play a significant role in future delivery of colon cancer surgery because of an increase in early-stage, node-negative disease due to national bowel cancer screening programmes. Traditionally, colon lymphatic drainage has not been thought relevant as the operative approach cannot be tailored. Recent advances in local and endoscopic risk-reducing interventions for colonic malignancy have caused a rethink in approach. SLNM was initially attempted with blue dye techniques with limited success. Technological improvement has allowed surgeons to use near-infrared (NIR) light and NIR active tracers such as indocyanine green. This review provides an overview of the current status of intraoperative lymph node mapping in the colon, identifies challenges to the delivery of the techniques, and discusses potential solutions that may help SLNM play a role in improving the delivery of surgical care for patients with colon cancer.

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“…Lately, studies with a recently developed hybrid optonuclear probe have been reported [107,108]. This new device allows the detection of both radioactive and fluorescent signals through integration of two optical fibers (one for excitation and the other for emission signal collection) into the handheld gamma probe.…”

Section: Lymphoscintigraphy Improves the Accuracy Of Sentinel Lymph Nmentioning

confidence: 99%

Melanoma & Nuclear Medicine: New Insights & Advances

et al. 2018

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The contribution of nuclear medicine to management of melanoma patients is increasing. In intermediate-thickness N0 melanomas, lymphoscintigraphy provides a roadmap for sentinel node biopsy. With the introduction of single-photon emission computed tomography images with integrated computed tomography (SPECT/CT), 3D anatomic environments for accurate surgical planning are now possible. Sentinel node identification in intricate anatomical areas (pelvic cavity, head/neck) has been improved using hybrid radioactive/fluorescent tracers, preoperative lymphoscintigraphy and SPECT/CT together with modern intraoperative portable imaging technologies for surgical navigation (free-hand SPECT, portable gamma cameras). Furthermore, PET/CT today provides 3D roadmaps to resect 18F-fluorodeoxyglucose-avid melanoma lesions. Simultaneously, in advanced-stage melanoma and recurrences, 18F-fluorodeoxyglucose-PET/CT is useful in clinical staging and treatment decision as well as in the evaluation of therapy response. In this article, we review new insights and recent nuclear medicine advances in the management of melanoma patients.

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First-in-human evaluation of a hybrid modality that allows combined radio- and (near-infrared) fluorescence tracing during surgery

Abstract: This study demonstrates the first-in-human evaluation of a hybrid modality capable of detecting both gamma and fluorescence signals during a surgical procedure. Fluorescence tracing could be performed in ambient light.

Cited by 48 publications

References 17 publications

Toward (Hybrid) Navigation of a Fluorescence Camera in an Open Surgery Setting

Toward (Hybrid) Navigation of a Fluorescence Camera in an Open Surgery Setting

Intraoperative Sentinel Node Mapping in the Colon: Potential and Pitfalls

Melanoma & Nuclear Medicine: New Insights & Advances

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