title: Characterization and evaluation of the artemis camera for fluorescence-guided cancer surgery.
abstract: OBJECTIVE
  Near-infrared (NIR) fluorescence imaging can provide the surgeon with real-time visualization of, e.g., tumor margins and lymph nodes. We describe and evaluate the Artemis, a novel, handheld NIR fluorescence camera.
  
  
  METHODS
  We evaluated minimal detectable cell numbers (FaDu-luc2, 7D12-IRDye 800CW), preclinical intraoperative detection of sentinel lymph nodes (SLN) using indocyanine green (ICG), and of orthotopic tongue tumors using 7D12-800CW. Results were compared with the Pearl imager. Clinically, three patients with liver metastases were imaged using ICG.
  
  
  RESULTS
  Minimum detectable cell counts for Artemis and Pearl were 2 × 10(5) and 4 × 10(4) cells, respectively. In vivo, seven SLNs were detected in four mice with both cameras. Orthotopic OSC-19-luc2-cGFP tongue tumors were clearly identifiable, and a minimum FaDu-luc2 tumor size of 1 mm(3) could be identified. Six human malignant lesions were identified during three liver surgery procedures.
  
  
  CONCLUSIONS
  Based on this study, the Artemis system has demonstrated its utility in fluorescence-guided cancer surgery.
authors.affiliation: Department of Radiology and Molecular Imaging, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: P B A A
authors.initials: PB
authors.lastname: van Driel
authors.forename: M
authors.initials: M
authors.lastname: van de Giessen
authors.forename: M C
authors.initials: MC
authors.lastname: Boonstra
authors.forename: T J A
authors.initials: TJ
authors.lastname: Snoeks
authors.forename: S
authors.initials: S
authors.lastname: Keereweer
authors.forename: S
authors.initials: S
authors.lastname: Oliveira
authors.forename: C J H
authors.initials: CJ
authors.lastname: van de Velde
authors.forename: B P F
authors.initials: BP
authors.lastname: Lelieveldt
authors.forename: A L
authors.initials: AL
authors.lastname: Vahrmeijer
authors.forename: C W G M
authors.initials: CW
authors.lastname: Löwik
authors.forename: J
authors.initials: J
authors.lastname: Dijkstra
mesh_terms: D000818:Animals; D002138:Calibration; D045744:Cell Line, Tumor; D004867:Equipment Design; D005260:Female; D049452:Green Fluorescent Proteins / Q000737:chemistry; D006801:Humans; D007208:Indocyanine Green / Q000737:chemistry; D008113:Liver Neoplasms / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D051379:Mice; D008807:Mice, Inbred BALB C; D008819:Mice, Nude; D008856:Microscopy, Fluorescence; D009362:Neoplasm Metastasis; D021701:Sentinel Lymph Node Biopsy; D059629:Signal-To-Noise Ratio; D019265:Spectroscopy, Near-Infrared / Q000295:instrumentation*; D014062:Tongue Neoplasms / Q000473:pathology*
chemical_list: D049452:Green Fluorescent Proteins; D007208:Indocyanine Green