Page 45 - Fluorescence-guided cancer surgery

Detection of breast cancer using methylene blue 43
Intraoperative near-infrared uorescence imaging system (Mini-FLARE)
Imaging procedures were performed using the Mini-Fluorescence-Assisted Resection and Exploration (Mini-FLARE) image-guided surgery system, as described earlier10. Brie y, the system consists of 2 wavelength isolated light sources: a “white” light source, generating 26,600 lx of 400–650 nm light, and a “near-infrared” light source, generating 1.08 mW/came of ≈ 670 nm light. Color video and NIR uorescence images are simultaneously acquired and displayed in real time using custom optics and software that separate the color video and NIR uorescence images. A pseudo-colored (lime green) merged image of the color video and NIR uorescence images is also displayed. The imaging head is attached to a exible gooseneck arm, which permits positioning of the imaging head at extreme angles virtually anywhere over the surgical eld. For intraoperative use, the imaging head and imaging system pole stand are wrapped in a sterile shield and drape (Medical Technique Inc., Tucson, AZ).
Ex vivo imaging and uorescence microscopy of resected lesion
After slicing of the resected lesion at the Pathology department, uorescence imaging was again performed with the mini-FLARE imaging system. Fluorescence microscopy images were obtained with the Odyssey Infrared Imaging System (LI-COR, USA).
Statistical analysis
For statistical analysis, SPSS statistical software package (Version 20.0, Chicago, IL) was used. Graphs were generated using GraphPad Prism Software (Version 5.01, La Jolla, CA). TBRs were calculated by dividing the uorescent signal of the tumor by uorescent signal of surrounding tissue. Patient age and body mass index (BMI) were reported in median and range and TBR was reported in mean and standard deviation. To compare patient characteristics, independent samples t-test and chi-square tests were used. To compare TBR and background signal between dose groups, independent samples t-test was used. P < 0.05 was considered signi cant.