Use of the indocyanine green mode to visualize the white light in esophagogastric surgery

2022 ◽  
Author(s):  
Rodrigo Kaibel ◽  
Eugenio Licardie ◽  
María Socas ◽  
Salvador Morales-Conde
Keyword(s):  
Indocyanine Green ◽  
White Light ◽  
Esophagogastric Surgery

Real-Time Overlapping of Indocyanine Green—Video Angiography With White Light Imaging for Vascular Neurosurgery: Technique, Implementation, and Clinical Experience

2020 ◽  
Vol 19 (4) ◽  
pp. 453-460 ◽  
Author(s):  
Dimitrios Athanasopoulos ◽  
Axel Heimann ◽  
Makoto Nakamura ◽  
Irini Kakaletri ◽  
Oliver Kempski ◽  
...  
Keyword(s):  
Blood Flow ◽  
Indocyanine Green ◽  
Real Time ◽  
White Light ◽  
Multispectral Imaging ◽  
Tissue Perfusion ◽  
Indocyanine Green Videoangiography ◽  
Black And White ◽  
Surgical Clip ◽  
Vascular Neurosurgery

Abstract BACKGROUND Fluorescent-guided techniques in vascular neurosurgery can be demonstrated via black and white indocyanine green videoangiography (ICG-VA). Multispectral imaging (MFL) is a new method, which overlaps fluorescence with the white light and provides a fluorescent white light augmented reality image to the surgeon. OBJECTIVE To investigate (a) whether MFL can enhance the visualization of the blood-flow with simultaneous visualization of the anatomic structures and (b) if MFL can ergonomically improve the microvascular surgical treatment compared to ICG-VA. METHODS A digital imaging of the blood flow after intravenous injection of ICG on 7 pigs was performed in real time under white light, standard fluorescence, and MFL. The blood flow was interrupted with a surgical clip, demonstrating the blockage of the blood flow. We prospectively included 30 patients with vascular deformities. The vasculature was visualized on the microscope's monitor and through the microscope's eyepiece. RESULTS In the animal experiment, the visualization of the anatomy and the blood flow under MFL produced high resolution images. The occlusion of blood vessels demonstrated sufficiently the blockage of tissue perfusion and its reperfusion after clip removal. During all 30 surgical cases, the MFL technique and the direct delivery of the pseudo-colored image through the eyepiece allowed for enhanced anatomic and dynamic data. CONCLUSION MFL was shown to be superior to the classic ICG-VA, delivering enhanced data and notably improving the workflow due to the simultaneous and precise white light visualization of the blood flow and the surrounding anatomic structures.

scholarly journals Infrared fluorescence guided pleural biopsy during thoracoscopy

2017 ◽  
Vol 176 (6) ◽  
pp. 18-21
Author(s):  
A. L. Akopov ◽  
G. V. Papayan ◽  
A. .. Karlson ◽  
I. V. Chistyakov ◽  
S. Yu. Dvoretskiy ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Prospective Study ◽  
Fluorescence Imaging ◽  
White Light ◽  
Pleural Cavity ◽  
Pleural Biopsy ◽  
Biopsy Specimens ◽  
Precise Diagnosis ◽  
Histological Verification

OBJECTIVE. The authors developed methods and assessment of efficacy of infrared fluorescence imaging of pleural carcinomatosis using indocyanine green (ICG). MATERIAL AND METHODS. The prospective study included 14 patients with malignant pleural carcinomatosis. All patients underwent standard thoracoscopy with pleural biopsy, then pleural cavity was examined under fluorescence control using ICG solution. Comparison of accuracy of biopsy materials obtained in white light and fluorescence was made. RESULTS. Signs of malignancy had 21 biopsy specimens out of 28, which were obtained in white light (in 12 patients out of 14). Research of biopsy specimens using fluorescence allowed doctors to make the precise diagnosis in all 14 patients, with 33 out of 34 biopsy materials being informative. CONCLUSIONS. Intraoperative application of infrared ICG fluorescence developed accuracy of biopsy and histological verification of the diagnosis.

scholarly journals A prospective single-center protocol for using near-infrared fluorescence imaging with indocyanine green during staging laparoscopy to detect small metastasis from pancreatic cancer

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sachiyo Shirakawa ◽  
Hirochika Toyama ◽  
Masahiro Kido ◽  
Takumi Fukumoto
Keyword(s):  
Clinical Trials ◽  
Indocyanine Green ◽  
White Light ◽  
Pancreatic Resection ◽  
Near Infrared ◽  
Abdominal Cavity ◽  
Local Treatment ◽  
Staging Laparoscopy ◽  
Major Surgery ◽  
Link Type

Abstract Background Pancreatic resection and radiotherapy are powerful tools in the multidisciplinary local treatment of pancreatic ductal adenocarcinoma (PDAC). However, 10–20% of patients with preoperatively resectable PDAC have radiographically occult metastases, which results in laparotomy without resection. This study aims to explore the utility of intraoperative near-infrared (NIR) imaging with indocyanine green (ICG) during staging laparoscopy to detect PDAC metastasis. Methods This prospective study will evaluate patients with radiographically non-metastatic PDAC before they undergo planned pancreatic resection or chemoradiotherapy. Enrolled patients will receive ICG intravenously (0.5 mg/kg) before the staging laparoscopy. During the staging laparoscopy, the abdominal cavity will be observed using standard white-light laparoscopic imaging and then using NIR-ICG imaging. Suspicious lesions that are detected using standard imaging and/or NIR-ICG imaging will be examined intraoperatively using frozen sections and permanent specimens. We will evaluate the benefit of NIR-ICG imaging based on its ability to identify additional liver or peritoneal lesions that were not detected during standard white-light imaging. Discussion This study will help establish the clinical utility of NIR-ICG imaging to more precisely identify metastases from radiographically non-metastatic PDAC. This approach may help avoid needless major surgery or radiotherapy. Trial registration This protocol was registered on April 1, 2017 on the UMIN Clinical Trials Registry: UMIN000025900 and February 26, 2019 on the Japan Registry of Clinical Trials: jRCT1051180076.

scholarly journals Integration of Indocyanine Green Videoangiography With Operative Microscope: Augmented Reality for Interactive Assessment of Vascular Structures and Blood Flow

2015 ◽  
Vol 11 (2) ◽  
pp. 252-258 ◽  
Author(s):  
Nikolay L Martirosyan ◽  
Jesse Skoch ◽  
Jeffrey R Watson ◽  
G Michael Lemole ◽  
Marek Romanowski ◽  
...  
Keyword(s):  
Blood Flow ◽  
Indocyanine Green ◽  
Real Time ◽  
Femoral Artery ◽  
White Light ◽  
Near Infrared ◽  
Field Of View ◽  
Fluorescence Angiography ◽  
Indocyanine Green Videoangiography ◽  
Operative Microscope

Abstract BACKGROUND Preservation of adequate blood flow and exclusion of flow from lesions are key concepts of vascular neurosurgery. Indocyanine green (ICG) fluorescence videoangiography is now widely used for the intraoperative assessment of vessel patency. OBJECTIVE Here, we present a proof-of-concept investigation of fluorescence angiography with augmented microscopy enhancement: real-time overlay of fluorescence videoangiography within the white light field of view of conventional operative microscopy. METHODS The femoral artery was exposed in 7 anesthetized rats. The dissection microscope was augmented to integrate real-time electronically processed near-infrared filtered images with conventional white light images seen through the standard oculars. This was accomplished by using an integrated organic light-emitting diode display to yield superimposition of white light and processed near-infrared images. ICG solution was injected into the jugular vein, and fluorescent femoral artery flow was observed. RESULTS Fluorescence angiography with augmented microscopy enhancement was able to detect ICG fluorescence in a small artery of interest. Fluorescence appeared as a bright-green signal in the ocular overlaid with the anatomic image and limited to the anatomic borders of the femoral artery and its branches. Surrounding anatomic structures were clearly visualized. Observation of ICG within the vessel lumens permitted visualization of the blood flow. Recorded video loops could be reviewed in an offline mode for more detailed assessment of the vasculature. CONCLUSION The overlay of fluorescence videoangiography within the field of view of the white light operative microscope allows real-time assessment of the blood flow within vessels during simultaneous surgical manipulation. This technique could improve intraoperative decision making during complex neurovascular procedures.

scholarly journals Pilot Clinical Trial of Indocyanine Green Fluorescence-Augmented Colonoscopy in High Risk Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Rahul A. Sheth ◽  
Pedram Heidari ◽  
Kevin Woods ◽  
Daniel Chung ◽  
Andrew T. Chan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
High Risk ◽  
Indocyanine Green ◽  
White Light ◽  
Imaging Modality ◽  
Lesion Detection ◽  
Wide Field ◽  
Indocyanine Green Fluorescence ◽  
High Risk Patients ◽  
Risk Patients

White light colonoscopy is the current gold standard for early detection and treatment of colorectal cancer, but emerging data suggest that this approach is inherently limited. Even the most experienced colonoscopists, under optimal conditions, miss at least 15–25% of adenomas. There is an unmet clinical need for an adjunctive modality to white light colonoscopy with improved lesion detection and characterization. Optical molecular imaging with exogenously administered organic fluorochromes is a burgeoning imaging modality poised to advance the capabilities of colonoscopy. In this proof-of-principle clinical trial, we investigated the ability of a custom-designed fluorescent colonoscope and indocyanine green, a clinically approved fluorescent blood pool imaging agent, to visualize polyps in high risk patients with polyposis syndromes or known distal colonic masses. We demonstrate (1) the successful performance of real-time, wide-field fluorescence endoscopy using off-the-shelf equipment, (2) the ability of this system to identify polyps as small as 1 mm, and (3) the potential for fluorescence imaging signal intensity to differentiate between neoplastic and benign polyps.

scholarly journals TRLS-04. NEAR INFRARED FLUORESCENT DYE LOCALIZES BRAIN METASTASIS PRIOR TO DURAL OPENING AND IS MORE SENSITIVE THAN WHITE LIGHT IN BRAIN METASTASIS SURGERY

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i9-i9
Author(s):  
Love Buch ◽  
Steve Cho ◽  
Ryan Salinas ◽  
Jasmin Hussain ◽  
John Lee
Keyword(s):  
Brain Metastasis ◽  
Indocyanine Green ◽  
Surgical Resection ◽  
White Light ◽  
Near Infrared ◽  
Tumor Detection ◽  
Fluorescent Dye ◽  
Tumor Identification ◽  
Sensitivity Specificity ◽  
Dural Opening

Abstract INTRODUCTION: To improve surgical resection of brain tumors, our lab has pioneered a novel fluorescent dye technique, Second-Window Indocyanine-Green (SWIG), that relies on passive delivery and accumulation of indocyanine-green (ICG) in neoplastic tissue via the enhanced permeability and retention effect. We hypothesize that SWIG can provide early localization of brain metastasis prior to dural opening and can improve identification of surgical margins. METHODS: Subjects were prospectively enrolled in clinical trial after informed consent. Approximately 24 hours prior surgery, subjects were infused intravenously with 2.5mg/kg or 5mg/kg of ICG. Intraoperatively, a dedicated near-infrared (NIR) camera was used to detect ICG signal. After bone flap removal, the NIR imaging system was positioned above the presumed location of tumor. Additional NIR images were obtained after dural opening, corticectomy, and after conventional white-light surgical resection. RESULTS: We enrolled 50 patients with 51 total intraparenchymal brain metastases (23 lung, 7 breast, 8 GU/GI, 4 melanoma, and 7 others). Prior to dural opening, NIR signal was identified in 35 patients at an average depth of 4.3mm with SBR = 5.3 + 3.7. In the seven patients where NIR signal could not be identified prior to dural opening, tumor depth was an average of 8.4mm from cortical surface. Upon dural opening and tumor identification, all 51 tumors demonstrated strong NIR signal with SBR = 6.2 + 2.8. With white light alone, sensitivity/specificity/PPV/NPV for tumor detection was 83%, 94%, 98%, 57%. With NIR, sensitivity/specificity/PPV/NPV for tumor detection was 100%, 29%, 85%, 100%. DISCUSSION: NIR fluorophores are superior to visible light fluorophores in their depth of penetration. All contrast-enhancing brain metastasis accumulate ICG using our SWIG technique, and NIR fluorescence could be used to localize brain metastasis prior to dural opening. NIR fluorophores are likely to represent the next phase in tumor visualization given the rapid growth of fluorophores targeted to systemic cancers.

FeXIV Line Emission Polarization of the July 11, 1991 Solar Corona

1994 ◽  
Vol 144 ◽  
pp. 541-547
Author(s):  
J. Sýkora ◽  
J. Rybák ◽  
P. Ambrož
Keyword(s):  
High Resolution ◽  
Solar Corona ◽  
Emission Line ◽  
Solar Eclipse ◽  
White Light ◽  
Preliminary Analysis ◽  
Line Emission ◽  
Total Solar Eclipse ◽  
Degree Of Polarization ◽  
High Resolution Images

AbstractHigh resolution images, obtained during July 11, 1991 total solar eclipse, allowed us to estimate the degree of solar corona polarization in the light of FeXIV 530.3 nm emission line and in the white light, as well. Very preliminary analysis reveals remarkable differences in the degree of polarization for both sets of data, particularly as for level of polarization and its distribution around the Sun’s limb.

White-Light Coronal Structures: Streamers and CMEs

1994 ◽  
Vol 144 ◽  
pp. 82
Author(s):  
E. Hildner
Keyword(s):  
Emission Line ◽  
Electron Density ◽  
White Light ◽  
Coronal Mass Ejections ◽  
X Rays ◽  
Solar Cycles ◽  
Temperature Function ◽  
X Ray ◽  
Eclipse Observations ◽  
Coronal Structures

AbstractOver the last twenty years, orbiting coronagraphs have vastly increased the amount of observational material for the whitelight corona. Spanning almost two solar cycles, and augmented by ground-based K-coronameter, emission-line, and eclipse observations, these data allow us to assess,inter alia: the typical and atypical behavior of the corona; how the corona evolves on time scales from minutes to a decade; and (in some respects) the relation between photospheric, coronal, and interplanetary features. This talk will review recent results on these three topics. A remark or two will attempt to relate the whitelight corona between 1.5 and 6 R⊙to the corona seen at lower altitudes in soft X-rays (e.g., with Yohkoh). The whitelight emission depends only on integrated electron density independent of temperature, whereas the soft X-ray emission depends upon the integral of electron density squared times a temperature function. The properties of coronal mass ejections (CMEs) will be reviewed briefly and their relationships to other solar and interplanetary phenomena will be noted.

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