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首页> 外文期刊>European Journal of Surgical Oncology: The Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology >Near-infrared fluorescence (NIRF) imaging in breast-conserving surgery: assessing intraoperative techniques in tissue-simulating breast phantoms.
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Near-infrared fluorescence (NIRF) imaging in breast-conserving surgery: assessing intraoperative techniques in tissue-simulating breast phantoms.

机译：保乳手术中的近红外荧光（NIRF）成像：评估组织模拟乳模中的术中技术。

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PURPOSE: Breast-conserving surgery (BCS) results in tumour-positive surgical margins in up to 40% of the patients. Therefore, new imaging techniques are needed that support the surgeon with real-time feedback on tumour location and margin status. In this study, the potential of near-infrared fluorescence (NIRF) imaging in BCS for pre- and intraoperative tumour localization, margin status assessment and detection of residual disease was assessed in tissue-simulating breast phantoms. METHODS: Breast-shaped phantoms were produced with optical properties that closely match those of normal breast tissue. Fluorescent tumour-like inclusions containing indocyanine green (ICG) were positioned at predefined locations in the phantoms to allow for simulation of (i) preoperative tumour localization, (ii) real-time NIRF-guided tumour resection, and (iii) intraoperative margin assessment. Optical imaging was performed using a custom-made clinical prototype NIRF intraoperative camera. RESULTS: Tumour-like inclusions in breast phantoms could be detected up to a depth of 21 mm using a NIRF intraoperative camera system. Real-time NIRF-guided resection of tumour-like inclusions proved feasible. Moreover, intraoperative NIRF imaging reliably detected residual disease in case of inadequate resection. CONCLUSION: We evaluated the potential of NIRF imaging applications for BCS. The clinical setting was simulated by exploiting tissue-like breast phantoms with fluorescent tumour-like agarose inclusions. From this evaluation, we conclude that intraoperative NIRF imaging is feasible and may improve BCS by providing the surgeon with imaging information on tumour location, margin status, and presence of residual disease in real-time. Clinical studies are needed to further validate these results.
机译：目的：保乳手术（BCS）可导致多达40％的患者出现肿瘤阳性手术切缘。因此，需要新的成像技术来为外科医生提供有关肿瘤位置和边缘状态的实时反馈。在这项研究中，在组织模拟乳腺体模中评估了BCS中近红外荧光（NIRF）成像在术前和术中肿瘤定位，切缘状态评估和残留疾病检测方面的潜力。方法：制作出的乳房状体模具有与正常乳腺组织相近的光学特性。将包含吲哚菁绿（ICG）的荧光肿瘤样夹杂物放置在体模中的预定位置，以模拟（i）术前肿瘤定位，（ii）实时NIRF指导的肿瘤切除和（iii）术中切缘评估。使用定制的临床原型NIRF术中相机进行光学成像。结果：使用NIRF术中摄像系统可以检测到高达21 mm深度的乳房幻影中的肿瘤状包裹体。实时NIRF引导切除肿瘤样内含物是可行的。此外，术中NIRF成像可在切除不充分的情况下可靠地检测出残留疾病。结论：我们评估了NIRF成像技术在BCS中的应用潜力。通过利用具有荧光肿瘤样琼脂糖包裹体的组织样乳腺模型来模拟临床情况。通过该评估，我们得出结论，术中NIRF成像是可行的，并且可以通过为外科医生提供有关肿瘤位置，边缘状态和残留疾病的实时成像信息来改善BCS。需要临床研究以进一步验证这些结果。

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