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J Nucl Med. 2016 Oct;57(10):1650-1653. Epub 2016 May 26.

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

Author information

1
Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
2
Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
3
Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
4
Institut für Informatik, Computer Aided Medical Procedures (CAMP), Technische Universität München, Munich, Germany SurgicEye GmbH, Munich, Germany; and.
5
Business Incubator, Development Center, Hamamatsu Photonics K.K., Hamamatsu City, Japan.
6
Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
7
Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands F.W.B.van_Leeuwen@lumc.nl.

Abstract

With the introduction of the hybrid tracer indocyanine green (ICG)-99mTc-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 medicine-based navigation concept that allowed intraoperative positioning of a fluorescence camera (FC) in the vicinity of preoperatively defined ICG-99mTc-nanocolloid containing sentinel nodes (SNs).

METHODS:

Five patients with penile cancer scheduled for SN biopsy were injected with ICG-99mTc-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.

RESULTS:

SPECT/CT identified 13 SNs in 9 groins. FC navigation was successful for all 12 intraoperatively evaluated SNs (average error, 8.8 mm; range, 0-20 mm).

CONCLUSION:

This study reveals the potential benefits of FC navigation during open surgery procedures.

KEYWORDS:

SPECT/CT; augmented reality; fluorescence imaging; navigation; sentinel node biopsy

PMID:
27230927
DOI:
10.2967/jnumed.115.171645
[Indexed for MEDLINE]
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