Performance of Two Clinical Fluorescence Imaging Systems with Different Targeted and Non-targeted Near-infrared Fluorophores: a Cadaveric Explorative Study

Overview

Journal Front Vet Sci

Specialty Veterinary Medicine

Date 2023 May 4

PMID 37138917

Authors

Lavinia E Chiti

Benjamin Husi

Brian Park

Patricia Beer

Faustine dOrchymont

Jason P Holland

Mirja C Nolff

Affiliations

Soon will be listed here.

Abstract

Introduction: Near-infrared (NIR) fluorescence-guided surgery is increasingly utilized in humans and pets. As clinical imaging systems are optimized for Indocyanine green (ICG) detection, the usage of targeted dyes necessitates the validation of these systems for each dye. We investigated the impact of skin pigmentation and tissue overlay on the sensitivity of two NIR cameras (IC-Flow, Visionsense VS3 Iridum) for the detection of non-targeted (ICG, IRDye800) and targeted (Angiostamp, FAP-Cyan) NIR fluorophores in an big animal model.

Methods: We quantitatively measured the limit of detection (LOD) and signal-to-background ratio (SBR) and implemented a semi-quantitative visual score to account for subjective interpretation of images by the surgeon.

Results: Visionsense VS3 Iridum outperformed IC-Flow in terms of LOD and SBR for the detection of all dyes except FAP-Cyan. Median SBR was negatively affected by skin pigmentation and tissue overlay with both camera systems. Level of agreement between quantitative and semi-quantitative visual score and interobserver agreement were better with Visionsense VS3 Iridum.

Conclusion: The overlay of different tissue types and skin pigmentation may negatively affect the ability of the two tested camera systems to identify nanomolar concentrations of targeted-fluorescent dyes and should be considered when planning surgical applications.

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References

Orosco R, Tsien R, Nguyen Q . Fluorescence imaging in surgery. IEEE Rev Biomed Eng. 2013; 6:178-87. PMC: 3762450. DOI: 10.1109/RBME.2013.2240294. View

Arz R, Seehusen F, Meier V, Nolff M . Indocyanine-based near-infrared lymphography for real-time detection of lymphatics in a cat with multiple mast cell tumours. JFMS Open Rep. 2022; 8(1):20551169221074961. PMC: 8891856. DOI: 10.1177/20551169221074961. View

Gorpas D, Koch M, Anastasopoulou M, Klemm U, Ntziachristos V . Benchmarking of fluorescence cameras through the use of a composite phantom. J Biomed Opt. 2017; 22(1):16009. DOI: 10.1117/1.JBO.22.1.016009. View

Jacques S . Optical properties of biological tissues: a review. Phys Med Biol. 2013; 58(11):R37-61. DOI: 10.1088/0031-9155/58/11/R37. View

Mery E, Golzio M, Guillermet S, Lanore D, Le Naour A, Thibault B . Fluorescence-guided surgery for cancer patients: a proof of concept study on human xenografts in mice and spontaneous tumors in pets. Oncotarget. 2018; 8(65):109559-109574. PMC: 5752542. DOI: 10.18632/oncotarget.22728. View

Kollias N, Baqer A . Spectroscopic characteristics of human melanin in vivo. J Invest Dermatol. 1985; 85(1):38-42. DOI: 10.1111/1523-1747.ep12275011. View

Widen J, Tholen M, Yim J, Bogyo M . Methods for analysis of near-infrared (NIR) quenched-fluorescent contrast agents in mouse models of cancer. Methods Enzymol. 2020; 639:141-166. DOI: 10.1016/bs.mie.2020.04.012. View

Samkoe K, Bates B, Tselepidakis N, DSouza A, Gunn J, Ramkumar D . Development and evaluation of a connective tissue phantom model for subsurface visualization of cancers requiring wide local excision. J Biomed Opt. 2017; 22(12):1-12. PMC: 5741805. DOI: 10.1117/1.JBO.22.12.121613. View

Zhu B, Rasmussen J, Sevick-Muraca E . A matter of collection and detection for intraoperative and noninvasive near-infrared fluorescence molecular imaging: to see or not to see?. Med Phys. 2014; 41(2):022105. PMC: 3987664. DOI: 10.1118/1.4862514. View

10.

Knapp D, Adams L, Degrand A, Niles J, Ramos-Vara J, Weil A . Sentinel lymph node mapping of invasive urinary bladder cancer in animal models using invisible light. Eur Urol. 2007; 52(6):1700-8. PMC: 2385787. DOI: 10.1016/j.eururo.2007.07.007. View

11.

Beer P, Rohrer-Bley C, Nolff M . Near-infrared fluorescent image-guided lymph node dissection compared with locoregional lymphadenectomies in dogs with mast cell tumours. J Small Anim Pract. 2022; 63(9):670-678. PMC: 9542114. DOI: 10.1111/jsap.13529. View

12.

Hernot S, van Manen L, Debie P, Mieog J, Vahrmeijer A . Latest developments in molecular tracers for fluorescence image-guided cancer surgery. Lancet Oncol. 2019; 20(7):e354-e367. DOI: 10.1016/S1470-2045(19)30317-1. View

13.

Lauwerends L, van Driel P, Baatenburg de Jong R, Hardillo J, Koljenovic S, Puppels G . Real-time fluorescence imaging in intraoperative decision making for cancer surgery. Lancet Oncol. 2021; 22(5):e186-e195. DOI: 10.1016/S1470-2045(20)30600-8. View

14.

Cabon Q, Sayag D, Texier I, Navarro F, Boisgard R, Virieux-Watrelot D . Evaluation of intraoperative fluorescence imaging-guided surgery in cancer-bearing dogs: a prospective proof-of-concept phase II study in 9 cases. Transl Res. 2016; 170:73-88. DOI: 10.1016/j.trsl.2015.12.001. View

15.

Kanniyappan U, Wang B, Yang C, Ghassemi P, Litorja M, Suresh N . Performance test methods for near-infrared fluorescence imaging. Med Phys. 2020; 47(8):3389-3401. PMC: 7496362. DOI: 10.1002/mp.14189. View

16.

Pop F, Veys I, Vankerckhove S, Barbieux R, Chintinne M, Moreau M . Absence of residual fluorescence in the surgical bed at near-infrared fluorescence imaging predicts negative margins at final pathology in patients treated with breast-conserving surgery for breast cancer. Eur J Surg Oncol. 2020; 47(2):269-275. DOI: 10.1016/j.ejso.2020.09.036. View

17.

Reynolds J, Troy T, Mayer R, Thompson A, Waters D, Cornell K . Imaging of spontaneous canine mammary tumors using fluorescent contrast agents. Photochem Photobiol. 1999; 70(1):87-94. View

18.

Wan J, Oblak M, Ram A, Singh A, Nykamp S . Determining agreement between preoperative computed tomography lymphography and indocyanine green near infrared fluorescence intraoperative imaging for sentinel lymph node mapping in dogs with oral tumours. Vet Comp Oncol. 2021; 19(2):295-303. DOI: 10.1111/vco.12675. View

19.

Hoogstins C, Burggraaf J, Koller M, Handgraaf H, Boogerd L, van Dam G . Setting Standards for Reporting and Quantification in Fluorescence-Guided Surgery. Mol Imaging Biol. 2018; 21(1):11-18. DOI: 10.1007/s11307-018-1220-0. View

20.

Favril S, Stock E, Hernot S, Hesta M, Polis I, Vanderperren K . Sentinel lymph node mapping by near-infrared fluorescence imaging and contrast-enhanced ultrasound in healthy dogs. Vet Comp Oncol. 2018; 17(1):89-98. DOI: 10.1111/vco.12449. View