吲哚菁绿近红外荧光成像在实验和临床实践中的应用潜力。

Potential of indocyanine green near-infrared fluorescence imaging in experimental and clinical practice.

机构信息

Institute of Surgery and Emergency Medicine, Pavlov First State Medical University of St. Petersburg, Lev Tolstoy Str. 6/8, 197022, St. Petersburg, Russia; Institute of Experimental Medicine, Federal Almazov Medical Research Centre, Akkuratova Str. 2, 197341, St. Petersburg, Russia; ITMO University, Kronverksky Avenue 49, 197101, St. Petersburg, Russia.

Institute of Surgery and Emergency Medicine, Pavlov First State Medical University of St. Petersburg, Lev Tolstoy Str. 6/8, 197022, St. Petersburg, Russia.

出版信息

Photodiagnosis Photodyn Ther. 2018 Dec;24:292-299. doi: 10.1016/j.pdpdt.2018.10.011. Epub 2018 Oct 16.

Abstract

BACKGROUND

Visualization of Indocyanine Green (ICG) near-infrared (NIR) fluorescence is a promising technique for biomedical applications because of its deep tissue penetration, low autofluorescence, weak dependence on ambient light, safety for patients and medical staff.

METHODS

To apply this technique to animal studies and clinical practice, we developed multispectral NIR fluorescence imaging system FLUM-808, which can be used in experimental studies and clinical practice, in open and endoscopic surgery (fluorescence-guided surgery). The object is illuminated either directly or through an illumination channel depending on what optical instrument is used (camera lens, fiber endoscope, rigid endoscope, surgical microscope, etc.). The system is able to simultaneously display NIR images and images captured under white light.

RESULTS

This article provides examples of imaging techniques used during open and endoscopic surgery with ICG as an NIR fluorescent dye and photosensitizer, demonstrates applications of the technique for experimental and clinical purposes: for intraoperative imaging of blood and lymphatic vessels; for detection of tumors and sentinel lymph nodes; for assessment of tissue, organ, or anastomotic blood supply.

CONCLUSIONS

This method significantly helps to accurately assign the areas of increased fluorescence to certain anatomical structures during surgery. NIR fluorescence diagnosis can be used in important experimental studies and in clinical practice. The described results of ICG studies can help in developing new fluorescence-based diagnostic and theranostic approaches employing more effective exogenous fluorophores and photosensitizers.

摘要

背景

吲哚菁绿(ICG)近红外(NIR)荧光的可视化是一种有前途的生物医学应用技术,因为它具有深组织穿透性、低自发荧光、对环境光的弱依赖性、对患者和医务人员的安全性。

方法

为了将该技术应用于动物研究和临床实践,我们开发了多光谱 NIR 荧光成像系统 FLUM-808,该系统可用于实验研究和临床实践,可在开放式和内窥镜手术(荧光引导手术)中使用。根据所使用的光学仪器(相机镜头、光纤内窥镜、刚性内窥镜、手术显微镜等),物体可以直接或通过照明通道进行照明。该系统能够同时显示 NIR 图像和白光下捕获的图像。

结果

本文提供了在开放式和内窥镜手术中使用 ICG 作为 NIR 荧光染料和光动力剂的成像技术示例,展示了该技术在实验和临床目的中的应用:用于术中血液和淋巴管的成像;用于检测肿瘤和前哨淋巴结;用于评估组织、器官或吻合血供。

结论

该方法在手术过程中显著有助于准确地将荧光增强区域分配给某些解剖结构。近红外荧光诊断可用于重要的实验研究和临床实践。所描述的 ICG 研究结果有助于开发新的基于荧光的诊断和治疗方法,使用更有效的外源性荧光团和光动力剂。

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