Maastricht University Medical Center, Maastricht, The Netherlands.
NUTRIM, Maastricht University, Maastricht, The Netherlands.
Surg Endosc. 2019 Mar;33(3):986-991. doi: 10.1007/s00464-018-6596-z. Epub 2018 Nov 26.
Ureteric injury is reported to occur in 1-7.6% of colorectal surgeries. To reduce the incidence of ureteral injury, it is essential to identify the ureters. The use of near-infrared fluorescence (NIRF) imaging with intravenously administered dyes might be of added value for ureteral visualization during laparoscopy. The aim of this study is to assess the performance of three preclinical dyes; IRDye 800BK, IRDye 800NOS and IRDye 800CW, for near-infrared fluorescence laparoscopy of the ureter in pigs.
In three female Dutch landrace pigs, the new dyes were evaluated. In each pig, 1 dye was tested using a 6-mg intravenous dose in a concentration of 1 mg/ml. Imaging was performed in fluorescence mode and white light mode with a laparoscopic imaging system. In order to further evaluate the dyes, an ex vivo imaging experiment was performed, in which 8 decreasing concentrations per dye, diluted in PBS, were evaluated in a transparent test tube with NIRF mode at a distance of 1, 5 and 10 cm from the laparoscope.
All three dyes were effective in allowing the identification of the ureter with NIRF imaging. The ureter became fluorescent after 35, 45 and 10 min, respectively, for IRDye 800BK, IRDye 800NOS and IRDye 800CW with a maximum target-to-background ratio (TBR) of 2.14, 0.66 and 1.44, respectively. In the ex vivo imaging experiment, all three dyes produced a strong fluorescence signal at all concentrations and all distances evaluated.
Intravenous administration of the preclinical dyes IRDye 800CW, IRDye 800 BK and IRDye 800NOS facilitated successful identification of the anatomical course of the ureter in living pig models. The highest measured TBR occurred with the use of IRDye 800BK. Ex vivo, a correlation was observed between the fluorescence intensities of the signal with the concentration of the dye and with the distance to the object.
据报道，输尿管损伤发生在 1-7.6%的结直肠手术中。为了降低输尿管损伤的发生率，识别输尿管至关重要。静脉内给予染料的近红外荧光（NIRF）成像可能对腹腔镜下输尿管可视化具有附加价值。本研究旨在评估三种临床前染料；IRDye 800BK、IRDye 800NOS 和 IRDye 800CW，用于猪腹腔镜下输尿管的近红外荧光成像。
在三只雌性荷兰长白猪中，评估了新染料。在每只猪中，使用 6mg 静脉剂量以 1mg/ml 的浓度测试 1 种染料。使用腹腔镜成像系统在荧光模式和白光模式下进行成像。为了进一步评估染料，进行了离体成像实验，其中以 NIRF 模式评估 8 种每种染料的浓度逐渐降低的稀释液，每种染料稀释于 PBS 中，在距离腹腔镜 1、5 和 10cm 的透明测试管中进行。
所有三种染料都能有效识别 NIRF 成像的输尿管。IRDye 800BK、IRDye 800NOS 和 IRDye 800CW 分别在 35、45 和 10 分钟后使输尿管发出荧光，最大靶标与背景比（TBR）分别为 2.14、0.66 和 1.44。在离体成像实验中，在所有评估的浓度和距离下，所有三种染料均产生强烈的荧光信号。
静脉内给予临床前染料 IRDye 800CW、IRDye 800BK 和 IRDye 800NOS，有助于在活体猪模型中成功识别输尿管的解剖路径。使用 IRDye 800BK 时测量的最高 TBR。离体实验中，观察到信号的荧光强度与染料浓度和与物体的距离之间存在相关性。
