title: Dynamic optical projection of acquired luminescence for aiding oncologic surgery.
abstract: Optical imaging enables real-time visualization of intrinsic and exogenous contrast within biological tissues. Applications in human medicine have demonstrated the power of fluorescence imaging to enhance visualization in dermatology, endoscopic procedures, and open surgery. Although few optical contrast agents are available for human medicine at this time, fluorescence imaging is proving to be a powerful tool in guiding medical procedures. Recently, intraoperative detection of fluorescent molecular probes that target cell-surface receptors has been reported for improvement in oncologic surgery in humans. We have developed a novel system, optical projection of acquired luminescence (OPAL), to further enhance real-time guidance of open oncologic surgery. In this method, collected fluorescence intensity maps are projected onto the imaged surface rather than via wall-mounted display monitor. To demonstrate proof-of-principle for OPAL applications in oncologic surgery, lymphatic transport of indocyanine green was visualized in live mice for intraoperative identification of sentinel lymph nodes. Subsequently, peritoneal tumors in a murine model of breast cancer metastasis were identified using OPAL after systemic administration of a tumor-selective fluorescent molecular probe. These initial results clearly show that OPAL can enhance adoption and ease-of-use of fluorescence imaging in oncologic procedures relative to existing state-of-the-art intraoperative imaging systems.
authors.affiliation: Washington University, School of Medicine, Department of Radiology, 4525 Scott Avenue, St. Louis, Missouri 63110.
authors.forename: Pinaki
authors.initials: P
authors.lastname: Sarder
authors.forename: Kyle
authors.initials: K
authors.lastname: Gullicksrud
authors.forename: Suman
authors.initials: S
authors.lastname: Mondal
authors.forename: Gail P
authors.initials: GP
authors.lastname: Sudlow
authors.forename: Samuel
authors.initials: S
authors.lastname: Achilefu
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Akers
mesh_terms: D000818:Animals; D005260:Female; D005456:Fluorescent Dyes; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007208:Indocyanine Green; D008207:Lymphatic Metastasis; D008325:Mammary Neoplasms, Experimental; D051379:Mice; D008807:Mice, Inbred BALB C; D009369:Neoplasms / Q000601:surgery*; D061848:Optical Imaging / Q000379:methods*; D010534:Peritoneal Neoplasms; D021701:Sentinel Lymph Node Biopsy; D025321:Surgery, Computer-Assisted / Q000379:methods*
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green