Leiden University Scholarly Publications

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Verbeek, F.P.R. (2015)

Image-guided cancer surgery : the value of near-infrared fluorescence imaging during oncologic and gastrointestinal procedures

Doctoral Thesis
Intraoperative imaging using near-infrared (NIR) fluorescence is a relatively new technique that can be used to visualize tumor tissue, sentinel nodes and vital anatomical structures. This thesis is divided in three parts. In part one the ability to visualize surgical margins using NIR fluorescence imaging is demonstrated. Tumor visualization is established using the clinically approved contrast agent indocyanine green, as well as newly developed tumor targeted probes. The proportion of laparoscopic procedures has steadily increased over the last two decades. A challenging aspect of this conversion to minimal invasive surgery is the lack of tactile information, making it of particular interest for the development and improvement of laparoscopic NIR fluorescence imaging systems. Part two focusses on the clinical implementation of NIR fluorescence guided sentinel lymph node mapping for several indications (e.g. breast, skin and vulvar cancer). Besides visualization of structures that...Show moreIntraoperative imaging using near-infrared (NIR) fluorescence is a relatively new technique that can be used to visualize tumor tissue, sentinel nodes and vital anatomical structures. This thesis is divided in three parts. In part one the ability to visualize surgical margins using NIR fluorescence imaging is demonstrated. Tumor visualization is established using the clinically approved contrast agent indocyanine green, as well as newly developed tumor targeted probes. The proportion of laparoscopic procedures has steadily increased over the last two decades. A challenging aspect of this conversion to minimal invasive surgery is the lack of tactile information, making it of particular interest for the development and improvement of laparoscopic NIR fluorescence imaging systems. Part two focusses on the clinical implementation of NIR fluorescence guided sentinel lymph node mapping for several indications (e.g. breast, skin and vulvar cancer). Besides visualization of structures that need to be resected (e.g. tumor tissue or sentinel nodes), NIR fluorescence has also the potential to be of value for the identification of structures that should be spared. In part three, we demonstrate the first-in-human application of NIR fluorescence guided ureteral visualization, and also the optimization of bile duct imaging for routine laparoscopic cholecystectomies.Show less
Laparoscopic surgery
Hepatopancreatobiliary surgery
Breast cancer
Colorectal Cancer
Near-infrared fluorescence
All authors
Verbeek, F.P.R.
Supervisor
Velde, C.J.H. van de
Co-supervisor
Vahrmeijer, A.L.
Qualification
Doctor (dr.)
Awarding Institution
Department of Surgery, Faculty of Medicine (LUMC), Leiden University
Date
2015-06-03
Publisher
Department of Surger, Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
ISBN (print)
9789461696557

Funding

Sponsorship
Dutch Cancer Society (UL 2010-4732), the Center for Translational Molecular Medicine (CTMM, DeCoDe and MUSIS projects) and the Leiden University Fund/Piso Kuperus