Development of a Surgical Navigation System with Beam Split and Fusion of the Visible and Near-Infrared Fluorescence_Journal of Biomedical Engineering

Authors：

 YANGXiaofeng ¹ , WUWei ² , WANGGuoan ²

1. Biomedical Engineering Center, Shanxi Medical University, Taiyuan 030001, China;
2. Taiyuan Saien Si Technology Development Co., Ltd. Taiyuan 030006, China;

Corresponding author：

YANGXiaofeng, Email: yxfylq@163.com

Keywords：

visible light; near-infrared fluorescence; beam split and fusion; surgical operation; navigation

DOI：

10.7507/1001-5515.20150082

Video：

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This paper presents a surgical optical navigation system with non-invasive, real-time, and positioning characteristics for open surgical procedure. The design was based on the principle of near-infrared fluorescence molecular imaging. The in vivo fluorescence excitation technology, multi-channel spectral camera technology and image fusion software technology were used. Visible and near-infrared light ring LED excitation source, multi-channel band pass filters, spectral camera 2 CCD optical sensor technology and computer systems were integrated, and, as a result, a new surgical optical navigation system was successfully developed. When the near-infrared fluorescence was injected, the system could display anatomical images of the tissue surface and near-infrared fluorescent functional images of surgical field simultaneously. The system can identify the lymphatic vessels, lymph node, tumor edge which doctor cannot find out with naked eye intra-operatively. Our research will guide effectively the surgeon to remove the tumor tissue to improve significantly the success rate of surgery. The technologies have obtained a national patent, with patent No. ZI.2011 1 0292374.1.

Citation： YANGXiaofeng, WUWei, WANGGuoan. Development of a Surgical Navigation System with Beam Split and Fusion of the Visible and Near-Infrared Fluorescence. Journal of Biomedical Engineering, 2015, 32(2): 455-459. doi: 10.7507/1001-5515.20150082 Copy

1.	BJORNSSON O G, MURPHY R, CHADWICK V S. Physiochemical studies of indocyanine green (ICG):absorbance/concentration relationship, pH tolerance and assay precision in various solvents[J]. Experientia, 1982, 38(12):1441-1442.
2.	FRANGIONI J V. In vivo near-infrared fluorescence imaging[J]. Current Opinion in Chemical Biology, 2003, 7(5):626-634.
3.	ALFORD R, SIMPSON H M, DUBERMAN J, et al. Toxicity of organic fluorophores used in molecular imaging:literature review[J]. Molecular Imaging, 2009, 8(6):341-354.
4.	SCHAAFSMA B E, MIEOG J S, HUTTEMAN M, et al. The clinical use of indocyaninegreen as near-infrared fluorescent contrast agent for image-guided oncologicsurgery[J]. J Surg Oncol. 2011; 104(3):323-332.
5.	POLOM K, MURAWA D, RHO Y S, et al. Current trends and emerging future of indocyanine green usage in surgery and oncology:a literature review[J]. Cancer, 2011, 117(21):4812-4822.
6.	LUO S, ZHANG E, SU Y, et al. A review of NIR dyes in cancer targeting and imaging[J]. Biomaterials, 2011, 32(29):7127-7138.
7.	MARSHALL M V, RASMUSSEN J C, TAN I C, et al. Near-infrared fluorescence imaging in humans with indocyanine green:a review and update[J]. Open Surg Oncol J (Online), 2010, 2(2):12-25.
8.	VAHRMEIJER A L, HUTTEMAN M, VAN DER VORST J R, et al. Image guided cancer surgery using near-infrared fluorescence[J]. Nat Rev Clin Oncol. 2013, 10(9):507-518.
9.	SEVICK-MURACA E M. Translation of near-infrared fluorescence imaging technologies:emerging clinical applications[J]. Annual Review of Medicine, 2012, 63:217-231.
10.	ALANDER J T, KAARTINEN I, LAAKSO A, et al. A review of indocyanine green fluorescent imaging in surgery[J]. International Journal of Biomedical Imaging, 2012, 2012:940585.
11.	KEEREWEER S, KERREBIJN J D F, VAN DRIEL P B A A, et al. Optical image-guided surgery--where do we stand?[J]. Molecular Imaging and Biology, 2011, 13(2):199-207.
12.	GIOUX S, CHOI H S, FRANGIONI J V. Image-guided surgery using invisible near-infrared light:fundamentals of clinical translation[J]. Molecular Imaging, 2010, 9(5):237-255.
13.	KELDER W, NIMURA H, TAKAHASHI N, et al. Sentinel node mapping with indocyanine green (ICG) and infrared ray detection in early gastric cancer:an accurate method that enables a limited lymphadenectomy[J]. European Journal of Surgical Oncology, 2010, 36(6):552-558.
14.	GASHEV A A, NAGAI T, BRIDENBAUGH E A. Indocyanine green and lymphatic imaging:current problems[J]. Lymphatic Research and Biology, 2010, 8(2):127-130.
15.	TANAKA E, OHNISHI S, LAURENCE R G, et al. Real-time intraoperative ureteral guidance using invisible near-infrared fluorescence[J]. The Journal of Urology, 2007, 178(5):2197-2202.
16.	TANAKA E, CHOI H S, HUMBLET V, et al. Real-time intraoperative assessment of the extrahepatic bile ducts in rats and pigs using invisible near-infrared fluorescent light[J]. Surgery, 2008, 144(1):39-48.
17.	AOKI T, YASUDA D, SHIMIZU Y, et al. Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection[J]. World Journal of Surgery, 2008, 32(8):1763-1767.
18.	BALACUMARASWAMI L, TAGGART D P. Intraoperative imaging techniques to assess coronary artery bypass graft patency[J]. The Annals of Thoracic Surgery, 2007, 83(6):2251-2257.
19.	WOITZIK J, HORN P, VAJKOCZY P, et al. Intraoperative control of extracranial-intracranial bypass patency by near-infrared indocyanine green videoangiography[J]. Journal of Neurosurgery, 2005, 102(4):692-698.
20.	BERNAL-GARCIA L M, CABEZUDO-ARTERO J M, ORTEGA-MARTINEZ M, et al. Fluorescence-guided resection with 5-aminolevulinic acid of an intramedullary tumor[J]. Neurocirugia (Asturias, Spain), 2010, 21(4):312-316.
21.	CRANE L M, THEMELIS G, ARTS H J, et al. Intraoperative near-infrared fluorescence imaging for sentinel lymph node detection in vulvar cancer:first clinical results[J]. Gynecologic Oncology, 2011, 120(2):291-295.

1. BJORNSSON O G, MURPHY R, CHADWICK V S. Physiochemical studies of indocyanine green (ICG):absorbance/concentration relationship, pH tolerance and assay precision in various solvents[J]. Experientia, 1982, 38(12):1441-1442.
2. FRANGIONI J V. In vivo near-infrared fluorescence imaging[J]. Current Opinion in Chemical Biology, 2003, 7(5):626-634.
3. ALFORD R, SIMPSON H M, DUBERMAN J, et al. Toxicity of organic fluorophores used in molecular imaging:literature review[J]. Molecular Imaging, 2009, 8(6):341-354.
4. SCHAAFSMA B E, MIEOG J S, HUTTEMAN M, et al. The clinical use of indocyaninegreen as near-infrared fluorescent contrast agent for image-guided oncologicsurgery[J]. J Surg Oncol. 2011; 104(3):323-332.
5. POLOM K, MURAWA D, RHO Y S, et al. Current trends and emerging future of indocyanine green usage in surgery and oncology:a literature review[J]. Cancer, 2011, 117(21):4812-4822.
6. LUO S, ZHANG E, SU Y, et al. A review of NIR dyes in cancer targeting and imaging[J]. Biomaterials, 2011, 32(29):7127-7138.
7. MARSHALL M V, RASMUSSEN J C, TAN I C, et al. Near-infrared fluorescence imaging in humans with indocyanine green:a review and update[J]. Open Surg Oncol J (Online), 2010, 2(2):12-25.
8. VAHRMEIJER A L, HUTTEMAN M, VAN DER VORST J R, et al. Image guided cancer surgery using near-infrared fluorescence[J]. Nat Rev Clin Oncol. 2013, 10(9):507-518.
9. SEVICK-MURACA E M. Translation of near-infrared fluorescence imaging technologies:emerging clinical applications[J]. Annual Review of Medicine, 2012, 63:217-231.
10. ALANDER J T, KAARTINEN I, LAAKSO A, et al. A review of indocyanine green fluorescent imaging in surgery[J]. International Journal of Biomedical Imaging, 2012, 2012:940585.
11. KEEREWEER S, KERREBIJN J D F, VAN DRIEL P B A A, et al. Optical image-guided surgery--where do we stand?[J]. Molecular Imaging and Biology, 2011, 13(2):199-207.
12. GIOUX S, CHOI H S, FRANGIONI J V. Image-guided surgery using invisible near-infrared light:fundamentals of clinical translation[J]. Molecular Imaging, 2010, 9(5):237-255.
13. KELDER W, NIMURA H, TAKAHASHI N, et al. Sentinel node mapping with indocyanine green (ICG) and infrared ray detection in early gastric cancer:an accurate method that enables a limited lymphadenectomy[J]. European Journal of Surgical Oncology, 2010, 36(6):552-558.
14. GASHEV A A, NAGAI T, BRIDENBAUGH E A. Indocyanine green and lymphatic imaging:current problems[J]. Lymphatic Research and Biology, 2010, 8(2):127-130.
15. TANAKA E, OHNISHI S, LAURENCE R G, et al. Real-time intraoperative ureteral guidance using invisible near-infrared fluorescence[J]. The Journal of Urology, 2007, 178(5):2197-2202.
16. TANAKA E, CHOI H S, HUMBLET V, et al. Real-time intraoperative assessment of the extrahepatic bile ducts in rats and pigs using invisible near-infrared fluorescent light[J]. Surgery, 2008, 144(1):39-48.
17. AOKI T, YASUDA D, SHIMIZU Y, et al. Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection[J]. World Journal of Surgery, 2008, 32(8):1763-1767.
18. BALACUMARASWAMI L, TAGGART D P. Intraoperative imaging techniques to assess coronary artery bypass graft patency[J]. The Annals of Thoracic Surgery, 2007, 83(6):2251-2257.
19. WOITZIK J, HORN P, VAJKOCZY P, et al. Intraoperative control of extracranial-intracranial bypass patency by near-infrared indocyanine green videoangiography[J]. Journal of Neurosurgery, 2005, 102(4):692-698.
20. BERNAL-GARCIA L M, CABEZUDO-ARTERO J M, ORTEGA-MARTINEZ M, et al. Fluorescence-guided resection with 5-aminolevulinic acid of an intramedullary tumor[J]. Neurocirugia (Asturias, Spain), 2010, 21(4):312-316.
21. CRANE L M, THEMELIS G, ARTS H J, et al. Intraoperative near-infrared fluorescence imaging for sentinel lymph node detection in vulvar cancer:first clinical results[J]. Gynecologic Oncology, 2011, 120(2):291-295.

Journal of Biomedical Engineering

Development of a Surgical Navigation System with Beam Split and Fusion of the Visible and Near-Infrared Fluorescence

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