First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows.,Nature Biomedical Engineering

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First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows.
Nature Biomedical Engineering ( IF 26.8 ) Pub Date : 2019-12-23 , DOI: 10.1038/s41551-019-0494-0
Zhenhua Hu _{1,

2} , Cheng Fang ₃ , Bo Li ₃ , Zeyu Zhang _{1,

4} , Caiguang Cao _{1,

2} , Meishan Cai _{1,

2} , Song Su ₃ , Xingwang Sun ₃ , Xiaojing Shi _{1,

2} , Cong Li _{1,

2} , Tiejun Zhou ₃ , Yuanxue Zhang ₃ , Chongwei Chi ₁ , Pan He ₃ , Xianming Xia ₃ , Yue Chen ₃ , Sanjiv Sam Gambhir ₅ , Zhen Cheng ₅ , Jie Tian _{1,

2,

4,

6}

Affiliation

The second near-infrared wavelength window (NIR-II, 1,000-1,700 nm) enables fluorescence imaging of tissue with enhanced contrast at depths of millimetres and at micrometre-scale resolution. However, the lack of clinically viable NIR-II equipment has hindered the clinical translation of NIR-II imaging. Here, we describe an optical-imaging instrument that integrates a visible multispectral imaging system with the detection of NIR-II and NIR-I (700-900 nm in wavelength) fluorescence (by using the dye indocyanine green) for aiding the fluorescence-guided surgical resection of primary and metastatic liver tumours in 23 patients. We found that, compared with NIR-I imaging, intraoperative NIR-II imaging provided a higher tumour-detection sensitivity (100% versus 90.6%; with 95% confidence intervals of 89.1%-100% and 75.0%-98.0%, respectively), a higher tumour-to-normal-liver-tissue signal ratio (5.33 versus 1.45) and an enhanced tumour-detection rate (56.41% versus 46.15%). We infer that combining the NIR-I/II spectral windows and suitable fluorescence probes might improve image-guided surgery in the clinic.

中文翻译：

在可见和近红外I / II窗口中通过多光谱荧光成像引导的首次人类肝脏肿瘤手术。

第二个近红外波长窗口（NIR-II，1,000-1,700 nm）使组织的荧光成像在毫米深度和微米分辨率下具有增强的对比度。但是，缺乏临床上可行的NIR-II设备阻碍了NIR-II成像的临床翻译。在这里，我们描述了一种光学成像仪器，该仪器将可见的多光谱成像系统与NIR-II和NIR-I（波长为700-900 nm）荧光（通过使用染料吲哚菁绿）的检测相结合，以辅助荧光引导手术切除原发性和转移性肝肿瘤23例。我们发现，与NIR-I成像相比，术中NIR-II成像提供更高的肿瘤检测灵敏度（100％比90.6％； 95％置信区间分别为89.1％-100％和75.0％-98.0％），更高的肿瘤与正常肝组织信号比（5.33对1.45）和更高的肿瘤检出率（56.41％对46.15％）。我们推断，将NIR-I / II光谱窗口与合适的荧光探针结合使用可能会改善临床中的图像引导手术。

更新日期：2019-12-25

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