Namikawa Tsutomu, Sato Takayuki, Hanazaki Kazuhiro
Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
Department of Cardiovascular Control, Kochi Medical School, Nankoku, Japan.
Surg Today. 2015 Dec;45(12):1467-74. doi: 10.1007/s00595-015-1158-7. Epub 2015 Mar 29.
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.
近红外（NIR）荧光成像具有更好的组织穿透性，能够有效排除激发光并检测器官深部情况。吲哚菁绿（ICG）在近红外光照射后产生近红外荧光，可实现术中实时经皮可视化浅表淋巴管和血管。HyperEye医疗系统（HEMS）能够在室内光线下同时检测近红外光以提供彩色成像，从而在强光下实现可视化。因此，使用ICG的近红外荧光成像在检测癌症前哨淋巴结和各种缺血性疾病的微血管循环方面具有出色的诊断准确性，有助于我们进行术中决策。将HEMS纳入该系统可进一步改善前哨淋巴结定位以及重建器官和缺血性疾病中术中血供的识别，使其比传统成像更具吸引力。此外，配备近红外的新型腹腔镜成像系统的开发将使微创环境下的荧光引导手术成为可能。未来的发展方向，包括将近红外荧光团与特定癌症标志物结合，可能成为具有诊断和治疗益处的实用技术。
