scholarly journals Bacteria-Targeted Fluorescence Imaging of Extracted Osteosynthesis Devices for Rapid Visualization of Fracture-Related Infections

2021 ◽  
Author(s):  
Marina López-Álvarez ◽  
Marjolein Heuker ◽  
Klaas A. Sjollema ◽  
Gooitzen M. van Dam ◽  
Jan Maarten van Dijl ◽  
...  
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Visual Information ◽  
Near Infrared ◽  
Trauma Surgery ◽  
Sterile Inflammation ◽  
Low Grade ◽  
Replica Plating ◽  
Time Image ◽  
Prompt Diagnosis

Abstract Purpose: Fracture-related infection (FRI) is a serious complication in orthopaedic trauma surgery worldwide. Especially the distinction of infection from sterile inflammation and the detection of low-grade infection are highly challenging. The objective of the present study was to explore the use of bacteria-targeted fluorescence imaging for enhanced detection of FRI on extracted osteosynthesis devices as a step-up towards real-time image-guided trauma surgery.Methods: Extracted osteosynthesis devices from 13 patients, who needed revision surgery after fracture treatment, were incubated with a near-infrared fluorescent tracer composed of the antibiotic vancomycin and the fluorophore IRDye800CW (i.e. vanco-800CW). Subsequently, the devices were imaged and vanco-800CW fluorescence signals were correlated to the results of microbiological culturing and to bacterial growth upon replica plating of the imaged devices on blood agar.Results: Importantly, compared to culturing, the bacteria-targeted fluorescence imaging of extracted osteosynthesis devices with vanco-800CW allows for a prompt diagnosis of FRI, reducing the time-to-result from days to less than 30 min. Moreover, bacteria-targeted imaging will provide surgeons with real-time visual information on the presence and extent of infection.Conclusion: Here we present the first clinical application of fluorescence imaging for detection of FRI. We conclude that imaging with vanco-800CW can provide early, accurate and real-time visual diagnostic information on FRI in the clinical setting, even in case of low-grade infections.

scholarly journals Intraoperative Near-Infrared Fluorescence Imaging With Second-Window Indocyanine-Green Offers Accurate and Real-Time Correction for Brain Shift and Anatomic Inconsistencies in Framless Neuronavigation

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Steve Sungwon Cho ◽  
Ashwin G Ramayya ◽  
Clare W Teng ◽  
Steven Brem ◽  
Sunil Singhal ◽  
...  
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Infrared Imaging ◽  
P Value ◽  
Brain Shift ◽  
Intracranial Tumors ◽  
Near Infrared Imaging ◽  
Near Infrared Fluorescence ◽  
Near Infrared Fluorescence Imaging

Abstract INTRODUCTION Neuronavigation allows neurosurgeons to localize intracranial structures in 3D space and has been shown to have positive impacts on patient survival in neuro-oncology surgery. However, its major limitation is the intraoperative brain-shift phenomenon, in which the brain moves during surgery due to physical, surgical, and/or biological factors, invalidating the preoperative registration and leading to inaccuracies in the cranium. One reliable way to account for brain-shift intraoperatively may be to use tumor-targeting near-infrared fluorophores, such as ICG accumulating in neoplastic tissue (ie, Second-Window ICG), which offers real-time visualization of tumors through normal cortex and dura. METHODS Patients undergoing craniotomy for primary resection of intracranial tumors were enrolled under an ongoing clinical trial investigating the efficacy of SWIG. For this analysis, retrospective data were collected on patients in whom neuronavigation was used to plan the craniotomy in such a way as to place the tumor in the center of the craniotomy (ie, parasagittal tumors, skull-base tumors, and large/asymmetrical tumors were excluded). During surgery, near-infrared imaging was performed before and after durotomy to localize the gross tumor. Image analysis was performed to measure the deviation between the craniotomy center and the center of the tumor as seen with near-infrared fluorescence. RESULTS A total of 63 patients (24 high-grade-gliomas, 12 meningiomas, 25 metastases, 2 others) were included in this preliminary analysis. Neuronavigation demonstrated a median deviation of 22.4% (range 7.7%-44.4%) relative to craniotomy size. Patient position was a significant predictor of neuronavigation inaccuracy, with the prone position having significantly higher inaccuracy (28.5 ± 8.8%) compared to the supine (19.3 ± 9.2%, P-value = .015) or the lateral (17.9 ± 6.6%, P-value = .012) positions. Additionally, the neuronavigation device used and postgraduate training level of the residents performing the registration trended towards significance on multivariate analysis. In contrast, near-infrared fluorescence perfectly delineated the tumor in all cases. CONCLUSION We demonstrate that near-infrared fluorescence imaging offers more accurate localization of intracranial tumors compared to frameless neuronavigation. Near-infrared imaging could potentially be used to adjust neuronavigation registrations intraoperatively to enhance accuracy. Further prospective studies with distance measurements could better explore this potential benefit of intraoperative near-infrared imaging.

Robotic Real-time Near Infrared Targeted Fluorescence Imaging in a Murine Model of Prostate Cancer: A Feasibility Study

Urology ◽  
2013 ◽  
Vol 81 (2) ◽  
pp. 451-457 ◽  
Author(s):  
Humberto Laydner ◽  
Steve S. Huang ◽  
Warren D. Heston ◽  
Riccardo Autorino ◽  
Xinning Wang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Real Time ◽  
Fluorescence Imaging ◽  
Feasibility Study ◽  
Murine Model ◽  
Near Infrared

scholarly journals Real-time near-infrared fluorescence imaging using cRGD-ZW800-1 for intraoperative visualization of multiple cancer types

Oncotarget ◽  
2017 ◽  
Vol 8 (13) ◽  
pp. 21054-21066 ◽  
Author(s):  
Henricus J.M. Handgraaf ◽  
Martin C. Boonstra ◽  
Hendrica A.J.M. Prevoo ◽  
Joeri Kuil ◽  
Mark W. Bordo ◽  
...  
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Multiple Cancer ◽  
Near Infrared Fluorescence ◽  
Cancer Types ◽  
Near Infrared Fluorescence Imaging ◽  
Intraoperative Visualization
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