title: Recent advances in near-infrared fluorescence-guided imaging surgery using indocyanine green.
abstract: Near-infrared (NIR) fluorescence imaging has better tissue penetration, allowing for the effective rejection of excitation light and detection deep inside organs. Indocyanine green (ICG) generates NIR fluorescence after illumination by an NIR ray, enabling real-time intraoperative visualization of superficial lymphatic channels and vessels transcutaneously. The HyperEye Medical System (HEMS) can simultaneously detect NIR rays under room light to provide color imaging, which enables visualization under bright light. Thus, NIR fluorescence imaging using ICG can provide for excellent diagnostic accuracy in detecting sentinel lymph nodes in cancer and microvascular circulation in various ischemic diseases, to assist us with intraoperative decision making. Including HEMS in this system could further improve the sentinel lymph node mapping and intraoperative identification of blood supply in reconstructive organs and ischemic diseases, making it more attractive than conventional imaging. Moreover, the development of new laparoscopic imaging systems equipped with NIR will allow fluorescence-guided surgery in a minimally invasive setting. Future directions, including the conjugation of NIR fluorophores to target specific cancer markers might be realistic technology with diagnostic and therapeutic benefits.
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan. tsutomun@kochi-u.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.affiliation: Department of Cardiovascular Control, Kochi Medical School, Nankoku, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D004396:Coloring Agents; D001026:Coronary Artery Bypass; D005453:Fluorescence; D006801:Humans; D007208:Indocyanine Green; D007259:Infrared Rays; D010535:Laparoscopy / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D065666:Mesenteric Ischemia / Q000473:pathology; D055806:Microvessels / Q000473:pathology; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009369:Neoplasms / Q000473:pathology; D025321:Surgery, Computer-Assisted / Q000379:methods* / Q000639:trends*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green
keywords: Fluorescence imaging; HyperEye Medical System; Indocyanine green; Navigation surgery; Near-infrared fluorescence
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