1.6 MHz FDML OCT for intraoperative imaging in neurosurgery

2021 ◽  
Author(s):  
D. Theisen-Kunde ◽  
W. Draxinger ◽  
M. M. Bonsanto ◽  
Paul Strenge ◽  
Nicolas Detrez ◽  
...  
Keyword(s):  
Intraoperative Imaging

Stellenwert der Navigation

2017 ◽  
Vol 01 (04) ◽  
pp. 317-334
Author(s):  
Jan-Sven Jarvers ◽  
Ulrich Spiegl ◽  
Stefan Glasmacher ◽  
Christoph Heyde ◽  
Christoph Josten
Keyword(s):  
Patient Safety ◽  
Radiation Exposure ◽  
Pedicle Screw ◽  
Spinal Surgery ◽  
Intraoperative Imaging ◽  
Intraoperative Navigation ◽  
Advantages And Disadvantages ◽  
Tumor Diseases ◽  
Intraoperative Control ◽  
Improved Technology

Abstract Importance of Navigation Navigation and intraoperative imaging have undergone an enormous development in recent years. By using intraoperative navigation, the precision of pedicle screw implantation can be increased in the sense of patient safety. Especially in the case of complex defects or tumor diseases, navigation is a decisive aid. As a result of the constantly improved technology, the requirements for reduced radiation exposure and intraoperative control can also be met. The high costs of the devices can be amortized, for example by a reduced number of revisions. This overview presents the principles of navigation in spinal surgery and the advantages and disadvantages of the different navigation procedures.

Image-Guided Spinal Surgery and Robotics in MIS: Where Are We Now?

2018 ◽  
Vol 1 (2) ◽  
pp. 2
Author(s):  
Chiung Chyi Shen
Keyword(s):  
Pedicle Screw ◽  
Spinal Surgery ◽  
Surgical Navigation ◽  
Improve Patient Safety ◽  
Intraoperative Imaging ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Image Guided

Use of pedicle screws is widespread in spinal surgery for degenerative, traumatic, and oncological diseases. The conventional technique is based on the recognition of anatomic landmarks, preparation and palpation of cortices of the pedicle under control of an intraoperative C-arm (iC-arm) fluoroscopy. With these conventional methods, the median pedicle screw accuracy ranges from 86.7% to 93.8%, even if perforation rates range from 21.1% to 39.8%.The development of novel intraoperative navigational techniques, commonly referred to as image-guided surgery (IGS), provide simultaneous and multiplanar views of spinal anatomy. IGS technology can increase the accuracy of spinal instrumentation procedures and improve patient safety. These systems, such as fluoroscopy-based image guidance ("virtual fluoroscopy") and computed tomography (CT)-based computer-guidance systems, have sensibly minimized risk of pedicle screw misplacement, with overall perforation rates ranging from between 14.3% and 9.3%, respectively."Virtual fluoroscopy" allows simultaneous two-dimensional (2D) guidance in multiple planes, but does not provide any axial images; quality of images is directly dependent on the resolution of the acquired fluoroscopic projections. Furthermore, computer-assisted surgical navigation systems decrease the reliance on intraoperative imaging, thus reducing the use of intraprocedure ionizing radiation. The major limitation of this technique is related to the variation of the position of the patient from the preoperative CT scan, usually obtained before surgery in a supine position, and the operative position (prone). The next technological evolution is the use of an intraoperative CT (iCT) scan, which would allow us to solve the position-dependent changes, granting a higher accuracy in the navigation system. 

Technetium-99m-based Radiopharmaceuticals in Sentinel Lymph Node Biopsy: Gynecologic Oncology Perspective

2018 ◽  
Vol 24 (15) ◽  
pp. 1652-1675 ◽  
Author(s):  
Kamil Zalewski ◽  
Malgorzata Benke ◽  
Bartlomiej Mirocha ◽  
Jakub Radziszewski ◽  
Magdalena Chechlinska ◽  
...  
Keyword(s):  
Half Life ◽  
Intraoperative Imaging ◽  
Gynecologic Oncology ◽  
Lymphatic Vessels ◽  
Diagnostic Procedures ◽  
Medical Personnel ◽  
Biological Properties ◽  
Lymph Node Biopsy ◽  
Regional Lymph Nodes ◽  
Extensive Lymphadenectomy

Technetium (99mTc)-radiolabeled colloids are popular tracers used to map lymphatic vessels and regional lymph nodes (LNs). The regional LN status is a significant determinant of cancer stage and patient prognosis, and strongly influences treatment. Regional LN dissection has become a part of surgical treatment. However, not all patients with LN involvement benefit from extensive lymphadenectomy in terms of prolonged survival. Moreover, overtreatment of patients with localized disease carries the unnecessary risk of complications. It is believed that sentinel LN biopsy (SLNB) allows to assess the involvement of the most representative LN of the lymphatic basin and to decide on radical LN dissection.99mTc is an easily available radionuclide emitting gamma rays. The value of 99mTc for diagnostic procedures is associated with its relatively short half-life that makes it safe both for patients and medical personnel. A colloid presenting specific physical and biological properties, including optimal particle size, is a carrier for the radionuclide. When administered at the tumor site, a radiocolloid is absorbed by the lymphatics, and the first LN that it gets trapped in is referred to as the sentinel LN (SLN). The radiopharmaceutical must reach the SLN relatively quickly, but its storage within the SLN, and the radionuclide’s half-life must be long enough to enable intraoperative imaging and evaluation. SLNB is currently the gold standard in breast cancer and malignant melanoma diagnosis, and is under extensive investigation in gynecological cancers. Here, we provide a historical perspective of the SLN concept and the clinical relevance of SLNB in gynecologic oncology. Moreover, we review the technical aspects of the application of 99mTc-based radiopharmaceuticals in lymphoscintigraphy and intraoperative lymphatic mapping.

scholarly journals Intraoperative imaging technology to maximise extent of resection for glioma: a network meta-analysis

2020 ◽  
Author(s):  
Daniel M Fountain ◽  
Andrew Bryant ◽  
Damiano Giuseppe Barone ◽  
Mueez Waqar ◽  
Michael G Hart ◽  
...  
Keyword(s):  
Intraoperative Imaging ◽  
Meta Analysis ◽  
Extent Of Resection ◽  
Imaging Technology

scholarly journals A non-toxic, reversibly released imaging probe for oral cancer that is derived from natural compounds

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Magda Ghanim ◽  
Nicola Relitti ◽  
Gavin McManus ◽  
Stefania Butini ◽  
Andrea Cappelli ◽  
...  
Keyword(s):  
Oral Cancer ◽  
Cancer Progression ◽  
Intraoperative Imaging ◽  
Critical Role ◽  
Water Soluble ◽  
Stem Cell Marker ◽  
Squamous Cells ◽  
Tissue Identification ◽  
Tumorigenic Potential ◽  
The Impact

AbstractCD44 is emerging as an important receptor biomarker for various cancers. Amongst these is oral cancer, where surgical resection remains an essential mode of treatment. Unfortunately, surgery is frequently associated with permanent disfigurement, malnutrition, and functional comorbidities due to the difficultly of tumour removal. Optical imaging agents that can guide tumour tissue identification represent an attractive approach to minimising the impact of surgery. Here, we report the synthesis of a water-soluble fluorescent probe, namely HA-FA-HEG-OE (compound 1), that comprises components originating from natural sources: oleic acid, ferulic acid and hyaluronic acid. Compound 1 was found to be non-toxic, displayed aggregation induced emission and accumulated intracellularly in vesicles in SCC-9 oral squamous cells. The uptake of 1 was fully reversible over time. Internalization of compound 1 occurs through receptor mediated endocytosis; uniquely mediated through the CD44 receptor. Uptake is related to tumorigenic potential, with non-tumorigenic, dysplastic DOK cells and poorly tumorigenic MCF-7 cells showing only low intracellular levels and highlighting the critical role of endocytosis in cancer progression and metastasis. Together, the recognised importance of CD44 as a cancer stem cell marker in oral cancer, and the reversible, non-toxic nature of 1, makes it a promising agent for real time intraoperative imaging.

scholarly journals Surgical Advances in Osteosarcoma

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 388
Author(s):  
Marcus J. Brookes ◽  
Corey D. Chan ◽  
Bence Baljer ◽  
Sachin Wimalagunaratna ◽  
Timothy P. Crowley ◽  
...  
Keyword(s):  
Fluorescent Dyes ◽  
Imaging Techniques ◽  
Intraoperative Imaging ◽  
Survival Rates ◽  
Computer Navigation ◽  
Bone Cancer ◽  
Technical Difficulty ◽  
Implant Design ◽  
Patient Specific ◽  
Patient Specific Instruments

Osteosarcoma (OS) is the most common primary bone cancer in children and, unfortunately, is associated with poor survival rates. OS most commonly arises around the knee joint, and was traditionally treated with amputation until surgeons began to favour limb-preserving surgery in the 1990s. Whilst improving functional outcomes, this was not without problems, such as implant failure and limb length discrepancies. OS can also arise in areas such as the pelvis, spine, head, and neck, which creates additional technical difficulty given the anatomical complexity of the areas. We reviewed the literature and summarised the recent advances in OS surgery. Improvements have been made in many areas; developments in pre-operative imaging technology have allowed improved planning, whilst the ongoing development of intraoperative imaging techniques, such as fluorescent dyes, offer the possibility of improved surgical margins. Technological developments, such as computer navigation, patient specific instruments, and improved implant design similarly provide the opportunity to improve patient outcomes. Going forward, there are a number of promising avenues currently being pursued, such as targeted fluorescent dyes, robotics, and augmented reality, which bring the prospect of improving these outcomes further.

scholarly journals Mannan-Based Nanodiagnostic Agents for Targeting Sentinel Lymph Nodes and Tumors

Molecules ◽  
2020 ◽  
Vol 26 (1) ◽  
pp. 146
Author(s):  
Markéta Jirátová ◽  
Andrea Gálisová ◽  
Maria Rabyk ◽  
Eva Sticová ◽  
Martin Hrubý ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Intraoperative Imaging ◽  
Tumor Model ◽  
Intercellular Adhesion Molecule ◽  
Internal Organs ◽  
Polymer Carriers ◽  
Polymer Conjugates ◽  
Imaging Tool ◽  
Imaging Probes

Early detection of metastasis is crucial for successful cancer treatment. Sentinel lymph node (SLN) biopsies are used to detect possible pathways of metastasis spread. We present a unique non-invasive diagnostic alternative to biopsy along with an intraoperative imaging tool for surgery proven on an in vivo animal tumor model. Our approach is based on mannan-based copolymers synergistically targeting: (1) SLNs and macrophage-infiltrated solid tumor areas via the high-affinity DC-SIGN (dendritic cell-specific intercellular adhesion molecule-3-grabbing non-integrin) receptors and (2) tumors via the enhanced permeability and retention (EPR) effect. The polymer conjugates were modified with the imaging probes for visualization with magnetic resonance (MR) and fluorescence imaging, respectively, and with poly(2-methyl-2-oxazoline) (POX) to lower unwanted accumulation in internal organs and to slow down the biodegradation rate. We demonstrated that these polymer conjugates were successfully accumulated in tumors, SLNs and other lymph nodes. Modification with POX resulted in lower accumulation not only in internal organs, but also in lymph nodes and tumors. Importantly, we have shown that mannan-based polymer carriers are non-toxic and, when applied to an in vivo murine cancer model, and offer promising potential as the versatile imaging agents.

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