Novel imaging system for positioning of the indocyanine green (ICG) target; visible projection of the near-infrared fluorescence image


Background: Even though NIR fluorescence imaging has many advantages in SLN mapping and cancer detection, NIR fluorescence imaging shows a serious drawback that NIR cannot be detected by the naked eye without any detectors. This limitation further disturbs accurate SLN detection and adequate tumor resection resulting in the presence of cancerous cells near the boundaries of surgically removed tissues. Materials and methods: To overcome the drawback of the conventional NIR imaging method, we suggest a novel NIR imaging system which can make the NIR fluorescence image visible to the naked eye as NIR fluorescence image detected by a video camera is processed by a computer and then projected back onto the NIR fluorescence excitation position with a projector using conspicuous color light. Image processing techniques were used for projection onto the exact position of the NIR fluorescence image. Also, we implemented a phantom experiment to evaluate the performance of the developed NIR fluorescence projection system by use of the ICG. Results: The developed NIR fluorescence projection system was applied in normal mouse model to confirm the usefulness of the system in the clinical field. A BALB/c nude mouse was prepared to be applied in normal mouse model and 0.25 mg/ml stock solution of the ICG was injected through a tail vein of the mouse. From the application in normal mouse model, we could confirm that the injected ICG stayed in the liver of the mouse and verify that the projection system projected the ICG fluorescence image at the exact location of the ICG by performing laparotomy of the mouse. Conclusions: From the application in normal mouse model, we could verify that the ICG fluorescence image was precisely projected back on the site where ICG fluorescence generated. It can be demonstrated that the NIR fluorescence projection system can make it possible to visualize the invisible NIR fluorescence image and to realize that SLN mapping and cancer detection in clinical surgery.

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Shin, I. , Kim, S. , Eom, J. , Park, J. , Park, H. , Park, I. and Lee, B. (2013) Novel imaging system for positioning of the indocyanine green (ICG) target; visible projection of the near-infrared fluorescence image. Journal of Biomedical Science and Engineering, 6, 896-900. doi: 10.4236/jbise.2013.69109.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Stepp, H., Beck, T., Pongratz, T., Meinel, T. Tonn, Ch. J., Kreth, F.W. and Stummer, W. (2007) ALA and malignant glioma: Fluorescence-guided resection and photodynamic treatment. Journal of Environmental Pathology, Toxicology and Oncology, 26, 157-164. doi:10.1615/JEnvironPatholToxicolOncol.v26.i2.110
[2] Ishizawa, T., Fukushima, N., Shibahara, J., Mauda, K., Tamura, S., Aoki, T., Hasegawa, K., Beck, Y., Fukayama, M. and Kokubo, N. (2009) Real-time identification of liver cancers by using Indocyanine green fluorescent imaging. Cancer, 115, 2491-2504. doi:10.1002/cncr.24291
[3] Nguyen, N.Q., Biankin, A.V., Leong, R.W., Chang, D.K., Cosman, P.H., Delaney, P., Kench, J.G. and Merrett, N.D. (2009) Real time intraoperative confocal laser microscopy guided surgery. Annals of Surgery, 249, 735-737. doi:10.1097/SLA.0b013e3181a38f11
[4] Miego, J.S.D., Hutteman, M., van der Vorst, J.R., Kuppen, P.J.K., Que, I., Dijkstra, J., Kaijzel, E.L., Prins, F., Lowik, C.W.G.M., Smit, V.T.H.B.M., van de Velde, C.J.H. and Vahrmeijer, A.L. (2011) Image-guided tumor resection using real-time near-infrared fluorescence in a syngeneic rat model of primary breast cancer. Breast Cancer Research and Treatment, 128, 279-689.
[5] Frangioni, J.V. (2008) New technologies for human cancer imaging. Journal of Clinical Oncology, 26, 4012-4021. doi:10.1200/JCO.2007.14.3065
[6] Hirche, C., Murawa, D., Mohr, Z., Kneif, S. and Hunerbein, M. (2010) ICG fluorescence-guided sentinel node biopsy for axillary nodal staging in breast cancer. Breast Cancer Research and Treatment, 121, 373-378. doi:10.1007/s10549-010-0760-z
[7] Hojo, T., Nagao, T., Kikuyama, M., Akashi, S. and Kinoshita, T. (2010) Evaluation of sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast, 19, 210-213. doi:10.1016/j.breast.2010.01.014
[8] Kitai, T., Inomoto, T., Miwa, M. and Shikayama, T. (2005) Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer, 12, 211-215. doi:10.2325/jbcs.12.211
[9] Murawa, D., Hirche, C., Dresel, S. and Hunerbein, M. (2009) Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence. British Journal of Surgery, 96, 1289-1294. doi:10.1002/bjs.6721
[10] Sevick-Muraca, E.M., Sharma, R., Rasmussen, J.C., Marshall, M.V., Wendt, J.A., Pham, H.Q., Bonefas, E., Houston, J.P., Sampath, L., Adams, K.E., Blanchard, D.K., Fisher, R.E., Chiang, S.B., Elledge, R. and Mawad, M.E. (2008) Imaging of lymph flow in breast cancer patients after microdose administration of a near-infrared fluorophore: Feasibility study. Radiology, 246, 734-741. doi:10.1148/radiol.2463070962
[11] Tagaya, N., Yamazaki, R., Nakagawa, A., Abe, A., Hamada, K., Kubota, K. and Oyama, T. (2008) Intraoperative identification of sentinel lymph nodes by near-infrared fluorescence imaging in patients with breast cancer. American Journal of Surgery, 195, 850-853. doi:10.1016/j.amjsurg.2007.02.032
[12] Tanaka, E., Chen, F.Y., Flaumenhaft, R., Graham, G.J., Laurence, R.G. and Frangioni, J.V. (2009) Real-time assessment of cardiac perfusion, coronary angiography, and acute intravascular thrombi using dual-channel near-infrared fluorescence imaging. Journal of Thoracic and Cardiovascular Surgery, 138, 133-140. doi:10.1016/j.jtcvs.2008.09.082 PMid:19577070 PMCid:2706783
[13] Troyan, S.L., Kianzad, V. and Gibbs-Strauss, S.L. (2009) The FLARE intraoperative near-infrared fluorescence imaging system: a first-in-human clinical trial in breast cancer sentinel lymph node mapping. Annals of Surgical Oncology, 16, 2943-2952. doi:10.1245/s10434-009-0594-2
[14] Miego, J.S.D., Troyan, S.L., Hutteman, M., Donohue, K.J., van der Vorst, J.R., Stockdale, A., Liefers, G.J., Choi, H.S., Gibbs-Strauss, S.L., Putter, H., Gioux, S., Kuppen, P.J.K., Ashitate, Y., Lowik, C.W.G.M., Smit, V.T.H.B.M., Oketokoun, R., Ngo, L.H., van de Velde, C.J.H., Frangioni, J.V. and Vahrmeijer, A.L. (2011) Towards optimization of imaging system and lymphatic tracer for near-infrared fluorescent sentinel lymph node mapping in breast cancer. Annals of Surgical Oncology, 18, 2483-2491. doi:10.1245/s10434-011-1566-x
[15] Giuliano, A.E., Kirgan, D.M., Geunther, J.M. and Morton, D.L. (1994) Lymapathic mapping and sentinel lymphadenectomy for breast cancer. Annals of Surgery, 220, 391-398. doi:10.1097/00000658-199409000-00015
[16] Cox, C.E., Pendas, S., Cox, J.M., Joseph, E., Shons, A.R., Yeatman, T., Ku, N.N., Lyman, G.H., Berman, C., Haddad, F. and Reintgen, D.S. (1998) Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer. Annals of Surgery, 227, 645-651. doi:10.1097/00000658-199805000-00005
[17] Liu, Y., Bauer, A.Q., Akers, W., Sudlow, G., Liang, K., Shen, D., Berezin, M., Culver, J.P. and Achilefu, S. (2011) Hands-free, wireless goggles for near-infrared fluorescence and real-time image-guided surgery. Journal of Surgery, 149, 689-698. doi:10.1016/j.surg.2011.02.007
[18] Collins, L., Schnitt, S., Achacoso, N., Fletcher, S., Nekhlyudov, L., Haque, R., Quesenberry, C. and Habel, L. (2009) Outcome of women with ductal carcinoma in situ treated with breast-conserving surgery alone: A case-control study of 225 patients from the cancer research network. Modern Pathology, 22, 34A-35A.
[19] Vicini, F.A., Kestin, L.L., Goldstein, N.S., Chen, P.Y., Pettinga, J., Frazier, R.C. and Martinez, A.A. (2000) Impact of young age on outcome in patients with ductal carci-noma in-situ treated with breast-conserving therapy. Journal of Clinical Oncology, 18, 296-306.

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