Fluorescence Imaging For Surgeons

This text presents the experiences of leading researchers and surgeons with different fluorescence methods. Chapters range from basic science of fluorescence to current clinical applications and new horizons. The first few chapters describe the historical evolution and physical principles of fluorescence and provide the foundation for the reader to understand the current scope and limits of its use in surgery. The second section focuses on the clinical applications of intraoperative fluorescence imaging including subsections on fluorescence cholangiography, applications to hepatectomy, lymph node navigation, applications to GI tract and pelvic surgery and identification of cancer tissues. The third section focuses on new frontiers including fluorescence probes, imaging systems and applications to photodynamic therapy. Authored by leaders in the development of fluorescent methods worldwide, Fluorescence Imaging for Surgeons: Concepts and Applications will have an impact on numerous medical specialists including general surgeons, colorectal and minimally-invasive surgeons and surgical oncologists. Researchers will find the book to be an invaluable resource on the latest advances in the utilization of nanoparticles and fluorescent probes.​

This book presents a comprehensive overview and outlook for the future of indocyanine green (ICG) fluorescence navigation surgery, which is attracting clinical interest as a safe and less invasive procedure not only in detecting cerebral vessels, coronary arteries, and biliary trees, but also in identifying sentinel lymph nodes in cancer. The book starts with the characteristics of ICG and photodynamic cameras/endoscopes, followed by detailed descriptions of the applications of ICG fluorescence imaging in various areas such as ocular surgery, neurosurgery, cardiovascular surgery, and plastic surgery. It also covers identifying sentinel lymph nodes in breast cancer as well as cancers of the gastrointestinal tract, and provides valuable information for hepato-biliary-pancreatic surgeons, such as identifying tattooing of liver segments and bile leakage. Written entirely by experts in their respective areas, ICG Fluorescence Imaging and Navigation Surgery offers an essential resource for surgeons operating on cancers and vascular disorders in the brain and cardiovascular systems and in plastic surgery.

This volume is a practical guide of theranostics using intraoperative fluorescence imaging technology, as an all-out effort by the Japanese Society for Fluorescence Guided Surgery. It describes the various approaches the technique is being used such as vascular imaging, identification of lymphatic vessels by intratissue injection, lymph node imaging, and imaging for identification of anatomical structures. The book is organized into three major parts and the first one delivers the basics, introducing the use of the technology in clinical settings and initial setups. Next comes the description of clinical applications where chapters illustrate perfusion assessment, cancer localization, anatomy visualization, and lymph nodes/ducts mapping. Each chapter is devoted to the specific surgical field and disease areas, presenting images and videos of case studies. The last part presents some upcoming techniques for treatments. The Editor and the authors wish the ideas presented here will be hints to bridge the knowledge between surgeons and basic researchers for further innovation and practicality. It is important to stay up-to-date since intraoperative fluorescence imaging has been applied to clinical settings in various surgical fields and at the same time, novel techniques improving the efficacy of the technology have also been developed actively. Fluorescence-Guided Surgery – From Lab to Operation Room is recommended for surgeons, operating nurses, medical experts, basic researchers and, industry engineers worldwide beyond boundaries of specialties. Edited and written by experts of The Japanese Society for Fluorescence-Guided Surgery, those who are the founders of the technology, it describes the accurate development history and cutting-edge techniques based on the knowledge accumulated over the years. ​

This text provides a state of the art overview of tools for guiding surgeons in the modern operating room. The text explains how many modalities in the current armamentarium of radiologic imaging have been brought to the operating room for real time use. It also explains the current use of near infrared, fluorescent, and chemo-luminescent imaging to guide minimally invasive and open surgery to improve outcome. The book is separated into two sections. The first, discusses the biologic principles that underlie novel visualization of normal organs and pathology. The currently available equipment and equipment anticipated in the near future is covered. The second section summarizes current clinical applications of advanced imaging and visualization in the OR. Novel means of visualizing normal anatomic structures such as nerves, bile duct, and vessels that enhance safety of many operations are covered. Novel biologic imaging using radio-labeled and fluorescent-labeled molecular probes that allow identification of inflammation, vascular abnormalities, and cancer are also discussed. Authored by scientists who pioneer research in optics and radiology, tool makers who use this knowledge to make surgical equipment, and surgeons who innovate the field of surgery using these new operative tools, Imaging and Visualization in the Modern Operating Room is a valuable guide for surgeons, residents and fellows entering the field.

The definitive textbook on state-of-the-art fluorescence-guided neurosurgery Advances in fluorescence-guided surgery (FGS) have resulted in a paradigm shift in neurosurgical approaches to neuro-oncological and cerebrovascular pathologies. Edited by two of the foremost authorities on the topic, Fluorescence-Guided Neurosurgery: Neuro-oncology and Cerebrovascular Applications encompasses the depth and breadth of this groundbreaking, still nascent technology. The book reflects significant contributions made by world renowned neurosurgeons Constantinos Hadjipanayis, Walter Stummer, and esteemed contributors on the growing uses of 5-aminolevulinic acid (5-ALA) and other FGS agents. The European Medicine Agency approved 5-ALA in 2007, heralding the birth of FGS globally. In 2017, the U.S. Food and Drug Administration approved 5-ALA (Gleolan) as an imaging agent to facilitate realtime detection and visualization of malignant tissue during glioma surgery. In the two decades since Dr. Stummer's initial description of 5-ALA FGS in a human patient, major strides have been made in its practical applications, leading to improved resection outcomes. As FGS is increasingly incorporated into neurosurgical practice, it holds promise for future innovations. Generously-illustrated and enhanced with online videos, this textbook is the definitive resource on the subject. Key Features The improved efficacy of 5-ALA for resecting high- and low-grade gliomas, recurrences, meningiomas, brain metastases, spinal cord tumors, pediatric brain tumors, and other adult tumors The future of fluorescence, including potentially powerful new fluorophores molecularly targeted specifically to tumors The use of the fluorescent agent indocyanine green (ICG) for brain tumors, cerebral aneurysms, AVMs, and cerebral vascularization Special topics such as fluorescein, illuminating tumor paint, confocal microscopy, Raman spectroscopy, and integrating FGS with intraoperative imaging and brain mapping This single accessible reference presents the current state-of-the-art on this emerging, exciting surgical technology. As such, it is a must-have for neurosurgical residents, fellows, and practicing neurosurgeons.

​This book represents a head-to-toe guide for clinicians who are interested in applying real-time near infrared (NIR) imaging for their patients. Expert surgeons from around the globe share their experience with NIR imaging, most commonly performed using indocyanine green (ICG) fluorescence. The chapters are structured to include a brief background, indications for use, followed by a technical description of the procedure. Each chapter is also accompanied by video examples and detailed information about necessary equipment, drug dosing, and alternative techniques. A pitfalls section serves as a “lessons learned” segment to bookend each chapter. Authors represent a comprehensive list of surgical subspecialties ranging from neurosurgery to plastic surgery. While it is not meant to serve as an exhaustive summary of ICG use in surgery, the goal is to highlight the successful use of this technology in a number of settings. As the technology and applications continue to expand, Video Atlas of Intraoperative Applications of Near Infrared Fluorescence Imaging serves as a foundation upon which to build.

Fluorescence-guided surgery (FGS) is a type of surgery that is performed with the guidance of fluorescence imaging. It has emerged as a new approach to detect the primary tumor, tumor margins, and metastatic lymph nodes. A major cause of tumor recurrence is the presence of residual tumor cells after surgery. Therefore, it is necessary to have a negative tumor margin to ensure a successful cancer resection. Despite widespread use of preoperative imaging techniques such as computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, and positron emission tomography (PET) scan, the surgical margin positive rate failed to reflect remarkable improvement. The plausible reason for this failure is the reliance of surgeons on the visual inspection and intraoperative histopathological analysis of the frozen tissue specimen. FGS is now emerging as an effective tool to guide the surgical oncologists by generating real time fluorescence images of the surgical region. It reduces the possibility of recurrence of cancer. This book strives to provide a fair idea about the fluorescence-guided surgery and to help develop a better understanding of the latest advances related to this medical procedure. It is a vital tool for all researching and studying fluorescence-guided surgery as it gives incredible insights into the emerging trends and concepts.