First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows

Zhenhua Hu^#^{1

2}, Cheng Fang^#³, Bo Li^#³, Zeyu Zhang^#^{1

4}, Caiguang Cao^{1

2}, Meishan Cai^{1

2}, Song Su³, Xingwang Sun³, Xiaojing Shi^{1

2}, Cong Li^{1

2}, Tiejun Zhou³, Yuanxue Zhang³, Chongwei Chi¹, Pan He³, Xianming Xia³, Yue Chen³, Sanjiv Sam Gambhir⁵, Zhen Cheng⁶, Jie Tian^{7

8

9

10}

Affiliations

¹ CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
² University of Chinese Academy of Sciences, Beijing, China.
³ Department of Hepatobiliary Surgery, Pathology and Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
⁴ Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China.
⁵ Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA, USA. sgambhir@stanford.edu.
⁶ Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA, USA. zcheng@stanford.edu.
⁷ CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China. tian@ieee.org.
⁸ University of Chinese Academy of Sciences, Beijing, China. tian@ieee.org.
⁹ Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China. tian@ieee.org.
¹⁰ Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China. tian@ieee.org.

^# Contributed equally.

PMID: 31873212
DOI: 10.1038/s41551-019-0494-0

First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows

Zhenhua Hu et al. Nat Biomed Eng. 2020 Mar.

. 2020 Mar;4(3):259-271.

doi: 10.1038/s41551-019-0494-0. Epub 2019 Dec 23.

Authors

Affiliations

¹ CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
² University of Chinese Academy of Sciences, Beijing, China.
³ Department of Hepatobiliary Surgery, Pathology and Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
⁴ Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China.
⁵ Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA, USA. sgambhir@stanford.edu.
⁶ Molecular Imaging Program at Stanford, Bio-X Program, and Department of Radiology, Canary Center at Stanford for Cancer Early Detection, Stanford University, Stanford, CA, USA. zcheng@stanford.edu.
⁷ CAS Key Laboratory of Molecular Imaging, Beijing Key Laboratory of Molecular Imaging, The State Key Laboratory of Management and Control for Complex Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China. tian@ieee.org.
⁸ University of Chinese Academy of Sciences, Beijing, China. tian@ieee.org.
⁹ Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China. tian@ieee.org.
¹⁰ Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Medicine, Beihang University, Beijing, China. tian@ieee.org.

^# Contributed equally.

PMID: 31873212
DOI: 10.1038/s41551-019-0494-0

Abstract

The second near-infrared wavelength window (NIR-II, 1,000-1,700 nm) enables fluorescence imaging of tissue with enhanced contrast at depths of millimetres and at micrometre-scale resolution. However, the lack of clinically viable NIR-II equipment has hindered the clinical translation of NIR-II imaging. Here, we describe an optical-imaging instrument that integrates a visible multispectral imaging system with the detection of NIR-II and NIR-I (700-900 nm in wavelength) fluorescence (by using the dye indocyanine green) for aiding the fluorescence-guided surgical resection of primary and metastatic liver tumours in 23 patients. We found that, compared with NIR-I imaging, intraoperative NIR-II imaging provided a higher tumour-detection sensitivity (100% versus 90.6%; with 95% confidence intervals of 89.1%-100% and 75.0%-98.0%, respectively), a higher tumour-to-normal-liver-tissue signal ratio (5.33 versus 1.45) and an enhanced tumour-detection rate (56.41% versus 46.15%). We infer that combining the NIR-I/II spectral windows and suitable fluorescence probes might improve image-guided surgery in the clinic.

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Comment in

Multispectral image-guided surgery in patients.
Choi HS, Kim HK. Choi HS, et al. Nat Biomed Eng. 2020 Mar;4(3):245-246. doi: 10.1038/s41551-020-0536-7. Nat Biomed Eng. 2020. PMID: 32165731 No abstract available.
Shining Near-Infrared Light on Image-guided Liver Surgery.
Luker GD. Luker GD. Radiol Imaging Cancer. 2020 Jan 31;2(1):e204003. doi: 10.1148/rycan.2020204003. eCollection 2020 Jan. Radiol Imaging Cancer. 2020. PMID: 33778698 Free PMC article. No abstract available.

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First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows

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First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows

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