Advancing Intraoperative Magnetic Tracing Using 3D Freehand Magnetic Particle Imaging

Overview

Journal Int J Comput Assist Radiol Surg

Publisher Springer

Specialties General Surgery
Radiology

Date 2021 Aug 1

PMID 34333740

Citations 12

Authors

Samaneh Azargoshasb

Lennert Molenaar

Giuseppe Rosiello

Tessa Buckle

Danny M van Willigen

Melissa M van de Loosdrecht

Mick M Welling

Lejla Alic

Fijs W B van Leeuwen

Alexander Winter

Matthias N van Oosterom

Affiliations

Soon will be listed here.

Abstract

Purpose: Sentinel lymph node biopsy is a routine procedure for nodal staging in penile cancer. Most commonly, this procedure is guided by radioactive tracers, providing various forms of preoperative and intraoperative guidance. This is further extended with fluorescence imaging using hybrid radioactive-fluorescence tracers. Alternatively, a magnetic-based approach has become available using superparamagnetic iron-oxide nanoparticles (SPIONs). This study investigates a novel freehand magnetic particle imaging and navigation modality (fhMPI) for intraoperative localization, along with a hybrid approach, combining magnetic and fluorescence guidance.

Materials And Methods: The fhMPI set-up was built with a surgical navigation device, optical tracking system and magnetometer probe. A dedicated reconstruction software based on a look-up-table method was used to reconstruct a superficial 3D volume of the SPION distribution in tissue. For fluorescence guidance, indocyanine green (ICG) was added to the SPIONs. The fhMPI modality was characterized in phantoms, ex vivo human skin and in vivo porcine surgery.

Results: Phantom and human skin explants illustrated that the current fhMPI modality had a sensitivity of 2.2 × 10 mg/mL SPIONs, a resolving power of at least 7 mm and a depth penetration up to 1.5 cm. Evaluation during porcine surgery showed that fhMPI allowed for an augmented reality image overlay of the tracer distribution in tissue, as well as 3D virtual navigation. Besides, using the hybrid approach, fluorescence imaging provided a visual confirmation of localized nodes.

Conclusion: fhMPI is feasible in vivo, providing 3D imaging and navigation for magnetic nanoparticles in the operating room, expanding the guidance possibilities during magnetic sentinel lymph node procedures. Furthermore, the integration of ICG provides the ability to visually refine and confirm correct localization. Further clinical evaluation should verify these findings in human patients as well.

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