Persistent URL of this record https://hdl.handle.net/1887/58921
Documents
-
- Download
- Title Pages_Contents
- open access
-
- Download
- Part I: Chapter 2
- open access
- Full text at publishers site
-
- Download
- Part I: Chapter 3
- open access
- Full text at publishers site
-
- Download
- Part I: Chapter 4
- open access
-
- Download
- Part II: Chapter 5
- open access
- Full text at publishers site
-
- Download
- Part II: Chapter 6
- open access
-
- Download
- Part II: Chapter 7
- open access
- Full text at publishers site
-
- Download
- Part II: Chapter 8
- open access
-
- Download
- Part III: Chapter 9
- open access
- Full text at publishers site
-
- Download
- Part III: Chapter 10
- open access
- Full text at publishers site
-
- Download
- Part III: Chapter 11
- open access
-
- Download
- Part IV: Chapter 12
- open access
-
- Download
- Part IV: Chapter 13
- open access
In Collections
This item can be found in the following collections:
Intraoperative fluorescence imaging : clinical translation of targeted and non-targeted tracers
Near-infrared fluorescence (NIRF) imaging is a technique that enhances contrast of certain structures during surgery and thereby improves their detectability [3, 4]. It uses targeted and non-targeted fluorescent tracers in combination with dedicated NIRF imaging systems. These tracers consist of fluorophores; molecules that emit fluorescence with a certain wavelength...Show moreSurgery is the cornerstone of curative treatment of many malignancies. However, incomplete resections and avoidable iatrogenic damage during surgery increase morbidity and mortality rates in patients. Although advances in preoperative imaging modalities have improved adequate patient selection and surgical planning, during procedures surgeons rely mainly on inspection and palpation. It is often very difficult to distinguish between fibrotic, inflamed, or malignant tissues [1]. Inspection and palpation are highly subjective and have low sensitivity for detecting cancer, especially for subcentimeter lesions [2].
Near-infrared fluorescence (NIRF) imaging is a technique that enhances contrast of certain structures during surgery and thereby improves their detectability [3, 4]. It uses targeted and non-targeted fluorescent tracers in combination with dedicated NIRF imaging systems. These tracers consist of fluorophores; molecules that emit fluorescence with a certain wavelength upon excitation by an external light source. These fluorescence signals can be captured by an imaging system optimized for that specific wavelength. Especially near-infrared wavelengths (i.e. 700-900 nm) have excellent characteristics, including relatively high tissue penetration capacity and low tissue autofluorescence, and are therefore preferably used for clinical applications [5]. NIRF imaging can identify targets covered by up to 10 mm tissue.
Non-targeted fluorescent tracers such as indocyanine green (ICG; emission peak 830 nm) and methylene blue (emission peak 700 nm) have been available for several decades, albeit for different indications. Their off-label use is safe and cheap, which contributed significantly to clinical experience and enabled NIRF imaging research to get momentum (chapter 2 and 3). NIRF imaging systems could be developed simultaneously with improved fluorophores. In general, NIRF-guided surgery has the potential to increase radical resection rates, while reducing avoidable iatrogenic damage. Both non-targeted as well as targeted tracers will be discussed, followed by the future perspectives of NIRF imaging.
Non-specificShow less
- All authors
- Handgraaf, H.J.M.
- Supervisor
- Velde, C.J.H. van de; Burggraaf, J.
- Co-supervisor
- Vahrmeijer, A.L.
- Committee
- Geus-Oei, L.F. de; Lelieveldt, B.P.F.; Löwik, C.W.G.M.; Bosscha, K.
- Qualification
- Doctor (dr.)
- Awarding Institution
- Medicine, Leiden University Medical Center (LUMC) , Leiden University
- Date
- 2018-01-09
- ISBN (print)
- 9789090307282