Localization of Pulmonary Nodules Using Navigation Bronchoscope and a Near-Infrared Fluorescence Thoracoscope

Anayama, Takashi; Qiu, Jimmy; Chan, Harley; Nakajima, Takahiro; Weersink, Robert A.; Daly, Michael J.; McConnell, Judy; Waddell, Thomas K.; Keshavjee, Shaf; Jaffray, David A.; Irish, Jonathan C.; Hirohashi, Kentaro; Wada, Hironobu; Orihashi, Kazumasa; Yasufuku, Kazuhiro

doi:10.1016/j.athoracsur.2014.07.050

Cited by 93 publications

(87 citation statements)

References 31 publications

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“…This characteristic offers an advantage compared to other fiducial markers that must be removed together with the pulmonary nodules during surgery, including liquid markers such as radiotracer, iodine, and barium. In a preclinical study at GTx Lab, we demonstrated a novel NIR thoracoscopic lung nodule localization technique using an injection of fluorescent ICG in vitro, and in vivo swine study (3). We then translated this novel technique into a clinical setting through a study in the GTx OR.…”

Section: Prospective Clinical Trials In the Gtx Ormentioning

confidence: 99%

“…These encouraging signs have led us to develop a preclinical EM navigational bronchoscopy system in the GTx Lab (3,4). The first step of EM navigation bronchoscopy is imaging to create a map of the chest.…”

Section: Iii) Study Using Combined Virtual 4-d Electromagnetic (Em) Tmentioning

confidence: 99%

“…To mitigate these issues, we examined other, less invasive, tumor localization methods (1,3,4). NIR imaging using ICG fluorescence has several unique advantages compared with other localization techniques.…”

Section: Prospective Clinical Trials In the Gtx Ormentioning

confidence: 99%

“…The cylindrical electromagnetic sensor (5-mm long, 0.8-mm diameter) (Aurora, Northern Digital, Waterloo, Canada) provides 6 degrees of freedom (x, y, z, pitch, yaw, roll). The sensor was integrated in the tip of the bronchoscope, which is a modification on the original model BF-MP160F (Olympus) (3). EM navigation bronchoscopic images are then registered to the 3D-CBCT images using in-house developed software for image-guided surgical procedures (16).…”

Section: Iii) Study Using Combined Virtual 4-d Electromagnetic (Em) Tmentioning

confidence: 99%

“…The GTx Lab also boasts several technologies that allow for advanced research to take place. This includes: a pair of pre-clinical animal operating rooms (OR) equipped with an endoscopic surgery system (Olympus), an electromagnetic (EM) navigation system developed in-house, a pre-clinical NIR fluorescence imaging system (SPY fluorescence imaging system, and PINPOINT endoscopic fluorescence imaging system, Novadaq), a micro-CT (Locus Ultra, GE Healthcare Life Sciences, Issaquah, USA) for small animal pre-clinical evaluation studies, CBCT (ARCADIS, Siemens) for large animal pre-clinical evaluation studies, and a pre-clinical 1.5T MRI (MAGNETOM Aera, Siemens) (3)(4)(5)(6)(7)(8).…”

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confidence: 99%

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Image-guided thoracic surgery in the hybrid operation room

2017

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Section: Prospective Clinical Trials In the Gtx Ormentioning

confidence: 99%

Section: Iii) Study Using Combined Virtual 4-d Electromagnetic (Em) Tmentioning

confidence: 99%

Section: Prospective Clinical Trials In the Gtx Ormentioning

confidence: 99%

Section: Iii) Study Using Combined Virtual 4-d Electromagnetic (Em) Tmentioning

confidence: 99%

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confidence: 99%

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Image-guided thoracic surgery in the hybrid operation room

2017

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Feasibility of real‐time near‐infrared indocyanine green fluorescence endoscopy for the evaluation of mucosal head and neck lesions

et al. 2016

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BackgroundThe purpose of this study was to explore the feasibility and potential drawbacks of near‐infrared (NIR) endoscopy with indocyanine green (ICG) to examine mucosal head and neck lesions.MethodsNIR ICG endoscopy was applied to image head and neck cancer epithelium in vivo. The evaluation of the ICG videos was performed off‐line independently by 2 evaluators and blinded with respect to final histopathological results from biopsies taken as the gold standard.ResultsForty percent of the lesions from 55 patients were histologically malignant. ICG positivity showed a sensitivity, specificity, and accuracy to be related to a malignant tumor of 90.5%, 90.9%, and 89.1%, respectively. The kappa index for the interobserver assessment showed a 94.4% agreement for the assessment of the ICG positivity. Side effects of the NIR ICG endoscopy did not arise.ConclusionNIR ICG endoscopy in patients with mucosal head and neck lesions was feasible and safe. It might help intraoperatively to differentiate benign from malignant lesions. © 2016 Wiley Periodicals, Inc. Head Neck 39: 234–240, 2017

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Feasibility study of navigated endoscopy for the placement of high dose rate brachytherapy applicators in the esophagus and lung

et al. 2020

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Purpose To evaluate the electromagnetic (EM) tracking of endoscopes and applicators as a method of positioning a high dose rate (HDR) luminal applicator. Method An anatomical phantom consisting of a rigid trachea and flexible esophagus was used to compare applicator placement measurements using EM tracking vs the traditional method using two‐dimensional (2D) fluoroscopy and surface skin markers. The phantom included a tumor in the esophagus and several pairs of optically visible points inside the lumen that were used to simulate proximal and distal ends of tumors of varying lengths. The esophagus tumor and lung points were visible on a computed tomography (CT) image of the phantom, which was used as ground truth for the measurements. The EM tracking system was registered to the CT image using fiducial markers. A flexible endoscope was tracked using the EM system and the locations of the proximal and distal ends of the tumor identified and this position recorded. An EM‐tracked applicator was then inserted and positioned relative to the tumor markings. The applicator path was mapped using the EM tracking. The gross tumor length (GTL) and the distance between the first dwell position and distal edge of tumor (offset) were measured using the EM tracking and 2D fluoroscopy methods and compared to the same measurements on the CT image. Results The errors in GTL using EM tracking were on average −0.5 ± 1.7 mm and 0.7 ± 3.6 mm for esophagus and lung measurements, similar to errors measured using the 2D fluoroscopy method of −0.9 ± 1.2 mm and 3.4 ± 4.4 mm. Offset measurements were slightly larger while using EM tracking relative to the fluoroscopy method but these were not statistically significant. Conclusions Electromagnetic tracking for placement of lumen applicators is feasible and accurate. Tracking of the endoscope that is used to identify the proximal and distal ends of the tumor and of the applicator during insertion generates accurate three‐dimensional measurements of the applicator path, GTL and offset. Guiding the placement of intraluminal applicators using EM navigation is potentially attractive for cases with complex insertions, such as those with nonlinear paths or multiple applicator insertions.

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Localization of Pulmonary Nodules Using Navigation Bronchoscope and a Near-Infrared Fluorescence Thoracoscope

Cited by 93 publications

References 31 publications

Image-guided thoracic surgery in the hybrid operation room

Image-guided thoracic surgery in the hybrid operation room

Feasibility of real‐time near‐infrared indocyanine green fluorescence endoscopy for the evaluation of mucosal head and neck lesions

Feasibility study of navigated endoscopy for the placement of high dose rate brachytherapy applicators in the esophagus and lung

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