near-infrared imaging

近红外成像
  • 文章类型: Journal Article
    硫化氢(H2S)可以作为与炎症发展密切相关的气体信号传导介质。在这项工作中,我们设计了一种基于分子间电荷转移(ICT)的荧光开启近红外(NIR)荧光探针T-H2S,用于检测活炎症细胞和斑马鱼中的H2S。在此基础上,选择双氰基异佛尔酮荧光团作为CIT-H2S的荧光信号报告基团,并构建了一个叠氮基团作为H2S的识别基团。ClT-H2S的特征在于对H2S相对于其他干扰物质的高选择性和灵敏度。661nm处的荧光强度在0~10μM的H2S浓度范围内呈良好的线性关系,具有优异的检测限(LOD),低至81.52nM。令人印象深刻的是,CIT-H2S已被可视化用于检测药物诱导的炎症细胞和斑马鱼模型中的H2S,因此表明CIT-H2S是一种强大的工具,能够研究硫化氢和炎症的发生和发展。
    Hydrogen sulfide (H2S) can act as a gaseous signaling mediator closely associated with inflammation development. In this work, we designed a fluorescence turn-on near-infrared (NIR) fluorescent probe CIT-H2S based on Intermolecular Charge Transfer (ICT) for the detection of H2S in living inflammatory cells and zebrafish. On this basis, a dicyanoisophorone fluorophore was chosen as the fluorescence signal reporting group of CIT-H2S, and an azide group was constructed as the recognition group of H2S. CIT-H2S is characterized by high selectivity and sensitivity for H2S over other interference species. The fluorescence intensity at 661 nm showed good linearity in the range of H2S concentration from 0 to 10 μM, with an excellent limit of detection (LOD) as low as 81.52 nM. Impressively, CIT-H2S has been visualized for detecting H2S in drug-induced inflammatory cell and zebrafish models, thus indicating that CIT-H2S is a robust tool with the ability to study the occurrence and development of hydrogen sulfide and inflammation.
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  • 文章类型: Journal Article
    目的:非肌层浸润性膀胱癌(NMIBC)的不完全切除增加了疾病复发的风险。通过分子探针进行成像引导的手术是减轻术后复发的关键策略。传统的光学分子探针,主要由靶向肿瘤细胞和荧光基团的抗体/肽组成,受到NMIBC细胞高度异质性的挑战,导致探头灵敏度不足。我们已经开发了一种胶原蛋白粘附探针(CA-P),以靶向肿瘤微环境中的胶原蛋白,旨在解决成像灵敏度不足的问题。
    方法:探讨胶原蛋白在动物膀胱癌模型和人膀胱癌组织中的分布特征。对CA-P的合成和性能进行了验证。在动物模型中,对CA-P的成像性能进行了测试,并与我们先前报道的近红外探头PLSWT7-DMI进行了比较.使用人离体膀胱组织评估CA-P的临床转化潜力。
    结果:胶原在肿瘤细胞表面的分布与其在正常尿路上皮中的表达不同。体外研究表明,CA-P能够在与胶原蛋白相互作用时经历“溶胶-凝胶”转变。在动物模型和人离体膀胱标本中,与PLSWT7-DMI相比,CA-P具有优越的成像性能。该探头的灵敏度为94.1%,特异性为81%。
    结论:CA-P证明了克服肿瘤细胞异质性和增强成像灵敏度的能力,在临床前模型中表现出良好的影像学结果。这些发现为CA-P在NMIBC术中导航中的应用提供了理论依据。
    OBJECTIVE: The incomplete resection of non-muscle invasive bladder cancer (NMIBC) augments the risk of disease recurrence. Imaging-guided surgery by molecular probes represents a pivotal strategy for mitigating postoperative recurrence. Traditional optical molecular probes, primarily composed of antibodies/peptides targeting tumour cells and fluorescent groups, are challenged by the high heterogeneity of NMIBC cells, leading to inadequate probe sensitivity. We have developed a collagen-adhesive probe (CA-P) to target the collagen within the tumour microenvironment, aiming to address the issue of insufficient imaging sensitivity.
    METHODS: The distribution characteristics of collagen in animal bladder cancer models and human bladder cancer tissues were explored. The synthesis and properties of CA-P were validated. In animal models, the imaging performance of CA-P was tested and compared with our previously reported near-infrared probe PLSWT7-DMI. The clinical translational potential of CA-P was assessed using human ex vivo bladder tissues.
    RESULTS: The distribution of collagen on the surface of tumour cells is distinct from its expression in normal urothelium. In vitro studies have demonstrated the ability of the CA-P to undergo a \"sol-gel\" transition upon interaction with collagen. In animal models and human ex vivo bladder specimens, CA-P exhibits superior imaging performance compared to PLSWT7-DMI. The sensitivity of this probe is 94.1%, with a specificity of 81%.
    CONCLUSIONS: CA-P demonstrates the capability to overcome tumour cell heterogeneity and enhance imaging sensitivity, exhibiting favorable imaging outcomes in preclinical models. These findings provide a theoretical basis for the application of CA-P in intraoperative navigation for NMIBC.
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  • 文章类型: Journal Article
    具有垂直堆叠的光电二极管和像素化光谱滤光片的单芯片成像设备正在推进癌症手术的多染料成像方法,尽管这种创新伴随着空间分辨率的妥协。为了减轻这个缺点,我们开发了一个深度卷积神经网络(CNN),旨在对颜色和近红外(NIR)通道进行去马赛克,在临床前和临床数据集上验证了其性能。
    我们引入了一种优化的深度CNN,旨在对使用六色成像传感器获得的彩色和近红外图像进行去马赛克。
    在彩色图像数据集上对残差CNN进行了微调和训练,随后在一系列双通道上进行了评估,颜色,和近红外图像,以证明其与传统双线性插值相比的增强性能。
    我们针对彩色和NIR图像进行去马赛克的优化CNN将彩色和NIR的均方误差降低了37%,将NIR的均方误差降低了40%,分别,在临床前数据中,两种成像方式的结构差异指数均提高了37%。在临床数据集中,该网络在彩色图像中将均方误差提高了35%,在NIR图像中将均方误差提高了42%,同时在两种成像方式中将结构相异指数提高了39%。
    我们通过使用为六色图像传感器量身定制的优化CNN,展示了颜色和NIR模式的图像分辨率增强。随着显卡计算能力的不断提高,我们的方法显著提高了分辨率,这对于在手术环境中实时执行是可行的.
    UNASSIGNED: Single-chip imaging devices featuring vertically stacked photodiodes and pixelated spectral filters are advancing multi-dye imaging methods for cancer surgeries, though this innovation comes with a compromise in spatial resolution. To mitigate this drawback, we developed a deep convolutional neural network (CNN) aimed at demosaicing the color and near-infrared (NIR) channels, with its performance validated on both pre-clinical and clinical datasets.
    UNASSIGNED: We introduce an optimized deep CNN designed for demosaicing both color and NIR images obtained using a hexachromatic imaging sensor.
    UNASSIGNED: A residual CNN was fine-tuned and trained on a dataset of color images and subsequently assessed on a series of dual-channel, color, and NIR images to demonstrate its enhanced performance compared with traditional bilinear interpolation.
    UNASSIGNED: Our optimized CNN for demosaicing color and NIR images achieves a reduction in the mean square error by 37% for color and 40% for NIR, respectively, and enhances the structural dissimilarity index by 37% across both imaging modalities in pre-clinical data. In clinical datasets, the network improves the mean square error by 35% in color images and 42% in NIR images while enhancing the structural dissimilarity index by 39% in both imaging modalities.
    UNASSIGNED: We showcase enhancements in image resolution for both color and NIR modalities through the use of an optimized CNN tailored for a hexachromatic image sensor. With the ongoing advancements in graphics card computational power, our approach delivers significant improvements in resolution that are feasible for real-time execution in surgical environments.
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  • 文章类型: Journal Article
    基于菁的近红外(NIR)荧光探针由于其低背景荧光干扰,在生物应用中发挥了重要作用。深层组织穿透,高灵敏度,对生物样品的光损伤最小。它们广泛用于分子识别,医学诊断,生物分子检测,和生物成像。在这里,我们提供了用于检测pH的基于花青的近红外荧光探针的最新进展,细胞,肿瘤及其在光热治疗(PTT)和光动力治疗(PDT)中的应用。
    Cyanine-based near-infrared (NIR) fluorescent probes have played vital roles in biological application due to their low interference from background fluorescence, deep tissue penetration, high sensitivity, and minimal photodamage to biological samples. They are widely utilized in molecular recognition, medical diagnosis, biomolecular detection, and biological imaging. Herein, we provide a review of recent advancements in cyanine-based NIR fluorescent probes for the detection of pH, cells, tumor as well as their application in photothermal therapy (PTT) and photodynamic therapy (PDT).
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  • 文章类型: Journal Article
    头颈部鳞状细胞癌(HNSCC)预后特别差。改善手术切除边界,减少局部复发,最终改善总体生存率是治疗目标。
    要获得完整的手术切除(R0切除),我们研究了靶向整合素亚型αvβ6的荧光成像探针的使用,该亚型在多种上皮癌中上调,使用动物模型。
    使用聚合酶链反应(PCR)和免疫蛋白印迹对人组织进行恶性肿瘤检测αvβ6表达。观察到蛋白质表达定位。αvβ6和表皮生长因子受体(EGFR)通过PCR和免疫蛋白印迹定量,并且使用细胞计数试剂盒-8测定法检查靶向αvβ6探针材料的生物安全性。吲哚菁绿(ICG)用作对照以确定探针在细胞水平上的定位。通过尾静脉注射进行体内动物实验以评估探针的成像效果并确认其在组织切片中的靶向性。
    αvβ6在HNSCC中的表达高于EGFR,并且该探针在体内和体外实验中显示出良好的靶向性,具有良好的安全性。
    ICG-αvβ6肽探针是一种特殊且灵敏的HNSCC成像工具,可以区分肿瘤,正常,和炎症组织。
    UNASSIGNED: Head and neck squamous cell carcinoma (HNSCC) has a particularly poor prognosis. Improving the surgical resection boundary, reducing local recurrence, and ultimately ameliorating the overall survival rate are the treatment goals.
    UNASSIGNED: To obtain a complete surgical resection (R0 resection), we investigated the use of a fluorescent imaging probe that targets the integrin subtype αvβ6, which is upregulated in many kinds of epithelial cancer, using animal models.
    UNASSIGNED: αvβ6 expression was detected using polymerase chain reaction (PCR) and immunoprotein blotting of human tissues for malignancy. Protein expression localization was observed. αvβ6 and epidermal growth factor receptor (EGFR) were quantified by PCR and immunoprotein blotting, and the biosafety of targeting the αvβ6 probe material was examined using Cell Counting Kit-8 assays. Indocyanine green (ICG) was used as a control to determine the localization of the probe at the cellular level. In vivo animal experiments were conducted through tail vein injections to evaluate the probe\'s imaging effect and to confirm its targeting in tissue sections.
    UNASSIGNED: αvβ6 expression was higher than EGFR expression in HNSCC, and the probe showed good targeting in in vivo and in vitro experiments with a good safety profile.
    UNASSIGNED: The ICG-αvβ6 peptide probe is an exceptional and sensitive imaging tool for HNSCC that can distinguish among tumor, normal, and inflammatory tissues.
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  • 文章类型: Journal Article
    两个由1,3,3-三甲基-3H-吲哚和3-喹啉受体组成的NAD(P)H-生物传感探针,通过噻吩连接,A,和3,4-亚乙基二氧噻吩,B,桥梁是详细的。我们合成了探针C和D,用苯基和2,1,3-苯并噻二唑单元代替探针A中的噻吩连接,分别。通过用1-甲基喹喔啉-1-鎓单元取代探针A的3-喹啉鎓单元来制备探针E。溶液是非荧光的,但在NADH的存在下,探针A和B在742.1nm和727.2nm处表现出近红外荧光,分别,并在690.6nm和685.9nm处产生吸光度信号。相比之下,探针C和D在450nm处显示出来自NADH荧光的明显干扰,而探针E对NAD(P)H的反应表现出最小的荧光变化。在探针A存在下用葡萄糖预处理A549细胞导致荧光强度显著增加。此外,将探针A与乳酸盐和丙酮酸盐分子接触会导致NAD(P)H水平发生相反的变化,乳酸引起荧光强度的大幅增加,相反,丙酮酸导致急剧下降。用不同浓度的药物顺铂治疗A549细胞,吉西他滨,和喜树碱(5,10和20μM)导致细胞内荧光强度的浓度依赖性增加,表示NAD(P)H水平上升。最后,用不同浓度的NADH和顺铂处理果蝇幼虫,说明对活生物体的适用性。结果表明,荧光强度与NADH和顺铂的浓度之间存在直接相关性,分别,进一步证实探针A在感测整个生物体内NAD(P)H水平变化中的功效。
    Two NAD(P)H-biosensing probes consisting of 1,3,3-trimethyl-3H-indolium and 3-quinolinium acceptors, linked by thiophene, A, and 3,4-ethylenedioxythiophene, B, bridges are detailed. We synthesized probes C and D, replacing the thiophene connection in probe A with phenyl and 2,1,3-benzothiadiazole units, respectively. Probe E was prepared by substituting probe A\'s 3-quinolinium unit with a 1-methylquinoxalin-1-ium unit. Solutions are non-fluorescent but in the presence of NADH, exhibit near-infrared fluorescence at 742.1 nm and 727.2 nm for probes A and B, respectively, and generate absorbance signals at 690.6 nm and 685.9 nm. In contrast, probes C and D displayed pronounced interference from NADH fluorescence at 450 nm, whereas probe E exhibited minimal fluorescence alterations in response to NAD(P)H. Pre-treatment of A549 cells with glucose in the presence of probe A led to a significant increase in fluorescence intensity. Additionally, subjecting probe A to lactate and pyruvate molecules resulted in opposite changes in NAD(P)H levels, with lactate causing a substantial increase in fluorescence intensity, conversely, pyruvate resulted in a sharp decrease. Treatment of A549 cells with varying concentrations of the drugs cisplatin, gemcitabine, and camptothecin (5, 10, and 20 μM) led to a concentration-dependent increase in intracellular fluorescence intensity, signifying a rise in NAD(P)H levels. Finally, fruit fly larvae were treated with different concentrations of NADH and cisplatin illustrating applicability to live organisms. The results demonstrated a direct correlation between fluorescence intensity and the concentration of NADH and cisplatin, respectively, further confirming the efficacy of probe A in sensing changes in NAD(P)H levels within a whole organism.
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  • 文章类型: Journal Article
    背景:第二窗口吲哚菁绿(SWIG)是一种新颖的术中成像技术,使用近红外(NIR)光进行术中肿瘤可视化,使用众所周知的荧光团吲哚菁绿(ICG)。因为神经鞘瘤通常会将神经整合到包裹的肿瘤中并撞击周围的神经结构,SWIG是一种有前途的技术,可以改善肿瘤切除,同时保留神经。
    目的:证明SWIG在脑神经鞘瘤切除中的应用。
    方法:三例脑神经鞘瘤患者(即,三叉神经,前庭,和迷走神经)接受SWIG引导切除。手术期间,间歇地使用NIR可视化来检测荧光以指导切除。然后计算信号背景比以定量荧光。
    结果:患者在手术前24小时以5.0mg/kg的剂量输注ICG。在6个月的随访中,每位患者均实现了完全或接近完全的切除,症状缓解,没有复发。计算的平均SBR为3.79,与SWIG引导切除其他脑和脊柱肿瘤的值相当。
    结论:本病例系列是首次发表的使用SWIG技术切除三叉神经和迷走神经神经鞘瘤的报告,表明SWIG可用于检测所有神经鞘瘤,和许多其他类型的脑肿瘤一样.本文还证明了术前ICG输注时机的重要性,并讨论了在最佳时机之外进行输注时可能观察到的NIR信号的反向模式。这为将来研究SWIG切除颅神经鞘瘤和其他脑肿瘤的研究提供了方向。
    Second Window Indocyanine Green (SWIG) is a novel intraoperative imaging technique that uses near-infrared (NIR) light for intra-operative tumor visualization using the well-known fluorophore indocyanine green (ICG). Because schwannomas often incorporate the nerve into the encapsulated tumor and impinge on surrounding neural structures, SWIG is a promising technique to improve tumor resection while sparing the nerve.
    To demonstrate the use of SWIG in resection of cranial nerve schwannomas.
    Three patients with cranial nerve schwannomas (i.e., trigeminal, vestibular, and vagus) underwent SWIG-guided resection. During surgery, NIR visualization was used intermittently used to detect fluorescence to guide resection. Signal-to-background ratio was then calculated to quantify fluorescence.
    Patients were infused with ICG at a dose of 5.0 mg/kg 24 hours before surgery. Each patient achieved total or near-total resection and relief of symptoms with lack of recurrence at six-month follow-up. The average SBR calculated was 3.79, comparable to values for SWIG-guided resection of other brain and spine tumors.
    This case series is the first published report of trigeminal and vagus nerve schwannoma resection using the SWIG technique and suggests that SWIG may be used to detect all schwannomas, alongside many other types of brain tumor. This paper also demonstrates the importance of preoperative ICG infusion timing and discusses the inverse pattern of NIR signal that may be observed when infusion occurs outside of the optimal timing. This provides direction for future studies investigating the administration of SWIG to resect cranial nerve schwannomas and other brain tumors.
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  • 文章类型: Journal Article
    对于骨肉瘤(OS)的治疗,必须完全切除所有具有较宽手术切缘的肿瘤组织。然而,这很难,有时是不可能的,实现由于看不见的小卫星病灶和模糊的肿瘤边界。此外,术中冰冻切片分析OS的切除边缘通常受到OS周围硬组织的限制,这使得不可能知道是否实现了负利润率。任何未切除的小肿瘤残留都会导致局部复发和预后恶化。在这里,基于B7H3在OS中的高表达,通过缀合抗B7H3抗体和IRDye800CW来合成靶向探针B7H3-IRDye800CW。B7H3-IRDye800CW可以在静脉给药后准确标记OS区域,从而帮助外科医生识别和切除残余OS病灶(<2mm)和肺转移病灶。在第3天肿瘤背景比达到4.42±1.77。用B7H3-IRDye800CW孵育新鲜的人OS样本后,它可以特异性标记OS区域甚至微侵袭区域(通过苏木精-伊红[HE]染色证实)。探针标记区域与磁共振成像和标本完全HE染色显示的肿瘤区域一致。总之,B7H3-IRDye800CW在术中切除指导和OS的快速病理诊断中具有转化潜力。
    Complete removal of all tumor tissue with a wide surgical margin is essential for the treatment of osteosarcoma (OS). However, it\'s difficult, sometimes impossible, to achieve due to the invisible small satellite lesions and blurry tumor boundaries. Besides, intraoperative frozen-section analysis of resection margins of OS is often restricted by the hard tissues around OS, which makes it impossible to know whether a negative margin is achieved. Any unresected small tumor residuals will lead to local recurrence and worse prognosis. Herein, based on the high expression of B7H3 in OS, a targeted probe B7H3-IRDye800CW is synthesized by conjugating anti-B7H3 antibody and IRDye800CW. B7H3-IRDye800CW can accurately label OS areas after intravenous administration, thereby helping surgeons identify and resect residual OS lesions (<2 mm) and lung metastatic lesions. The tumor-background ratio reaches 4.42 ± 1.77 at day 3. After incubating fresh human OS specimen with B7H3-IRDye800CW, it can specifically label the OS area and even the microinvasion area (confirmed by hematoxylin-eosin [HE] staining). The probe labeled area is consistent with the tumor area shown by magnetic resonance imaging and complete HE staining of the specimen. In summary, B7H3-IRDye800CW has translational potential in intraoperative resection guidance and rapid pathological diagnosis of OS.
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  • 文章类型: Journal Article
    功能化的单壁碳纳米管(SWCNT)由于其生物相容性和光学特性,在各种生物医学应用中具有巨大的潜力。包括近红外荧光。具体来说,SWCNT已被用于靶向细胞作为药物递送和基因治疗的载体,并作为各种细胞内生物标志物的传感器。虽然SWCNT进入细胞的主要内化途径是胞吞作用,增强SWCNT细胞摄取的方法非常重要。在这项研究中,我们证明了转染试剂用于促进功能化SWCNT的细胞内化的用途。我们探索了不同类型的SWCNT官能化,即单链DNA(ssDNA)或聚乙二醇(PEG)-脂质,和两种不同的细胞类型,胚胎肾细胞和腺癌细胞。我们表明,内化聚乙二醇化官能化的SWCNT在转染试剂的存在下增强,其中效果对于带负电荷的PEG-脂质更明显。然而,ssDNA-SWCNT倾向于在转染试剂的存在下形成聚集体,使其不适合促进内化。对于所有情况,通过近红外荧光显微镜观察细胞摄取,表明SWCNT通常位于溶酶体内。一般来说,细胞内化在腺癌细胞中更高,从而为恶性细胞中的药物递送和传感开辟了新的途径。
    Functionalized single-walled carbon nanotubes (SWCNTs) hold immense potential for diverse biomedical applications due to their biocompatibility and optical properties, including near-infrared fluorescence. Specifically, SWCNTs have been utilized to target cells as a vehicle for drug delivery and gene therapy, and as sensors for various intracellular biomarkers. While the main internalization route of SWCNTs into cells is endocytosis, methods for enhancing the cellular uptake of SWCNTs are of great importance. In this research, we demonstrate the use of a transfecting reagent for promoting cell internalization of functionalized SWCNTs. We explore different types of SWCNT functionalization, namely single-stranded DNA (ssDNA) or polyethylene glycol (PEG)-lipids, and two different cell types, embryonic kidney cells and adenocarcinoma cells. We show that internalizing PEGylated functionalized SWCNTs is enhanced in the presence of the transfecting reagent, where the effect is more pronounced for negatively charged PEG-lipid. However, ssDNA-SWCNTs tend to form aggregates in the presence of the transfecting reagent, rendering it unsuitable for promoting internalization. For all cases, cellular uptake is visualized by near-infrared fluorescence microscopy, showing that the SWCNTs are typically localized within the lysosome. Generally, cellular internalization was higher in the adenocarcinoma cells, thereby paving new avenues for drug delivery and sensing in malignant cells.
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  • 文章类型: Journal Article
    目的:当前建立的前哨淋巴结(SLN)活检技术是术前注射99mtech标记的纳米胶体(99mTc),然后进行单光子发射计算机断层扫描和标准计算机断层扫描(SPECT/CT),随后进行术中伽玛探针引导的SLN切除。然而,它是时间和资源消耗,由于注射是在清醒的患者中进行的,因此会导致患者的辐射暴露和发病。最近,吲哚菁绿(ICG)的近红外成像作为一种更快,更方便的技术在SLN活检中变得越来越重要。我们研究的目的是探讨在早期口腔鳞状细胞癌(OSCC)中使用ICG成像进行SLN活检的可行性。
    方法:对5例早期OSCC患者进行单中心试验研究。对于所有患者来说,进行了两种技术(99mTc和ICG).我们在术前给清醒的病人注射99mTc,其次是SPECT/CT成像。术中在原发肿瘤周围注射ICG。然后根据SPECT/CT图像进行颈部切口,并在术中使用伽马探针和ICG标记的淋巴结的近红外荧光成像检测SLN。根据SLN解剖方案将切除的淋巴结送至组织病理学检查。
    结果:在所有5例患者中,前哨淋巴结均得到确认。注射99mTc后,共鉴定出7个SLN,用SPECT/CT成像和术中使用伽马探头。所有这些SLN都是荧光的并且用ICG技术可见。在两个病人中,我们可以使用ICG技术识别其他淋巴结。病理分析显示其中2例隐匿性转移。
    结论:我们的研究表明,ICG引导的SLN活检是一种可行的技术,特别是与常规放射性同位素方法相结合,可能有助于SLN的术中定位。需要对更大的患者队列进行验证研究来证明我们的结果。
    OBJECTIVE: The current established technique for sentinel lymph node (SLN) biopsy is preoperative injection of 99mtechnetium-labeled nanosized colloids (99mTc) followed by single photon emission computed tomography and standard computed tomography (SPECT/CT) with subsequent intraoperative gamma probe-guided excision of the SLN. It is however time and resource consuming, causes radiation exposure and morbidity for the patient as the injection is done in the awake patient. Recently near-infrared imaging with indocyanine green (ICG) gained importance in SLN biopsy as a faster and more convenient technique. The objective of our study was to investigate the feasibility of SLN biopsy using ICG-imaging in early oral squamous cell carcinoma (OSCC).
    METHODS: Single-centre pilot study of five patients with early-stage OSCC. For all patients, both techniques (99mTc and ICG) were performed. We injected 99mTc preoperatively in the awake patient, followed by SPECT/CT imaging. Intraoperatively ICG was injected around the primary tumor. Then the neck incision was performed according to the SPECT/CT images and SLN were detected by using a gamma probe and near-infrared fluorescence imaging of the ICG-marked lymph nodes intraoperatively. The excised lymph nodes were sent to histopathological examination according to the SLN dissection protocol.
    RESULTS: In all five patients sentinel lymph nodes were identified. A total of 7 SLN were identified after injection of 99mTc, imaging with SPECT/CT and intraoperative use of a gamma probe. All these SLN were fluorescent and visible with the ICG technique. In two patients, we could identify additional lymph nodes using the ICG technique. Pathological analysis demonstrated occult metastasis in two of the cases.
    CONCLUSIONS: Our study shows that ICG-guided SLN biopsy is a feasible technique, especially in combination with conventional radioisotope method and may help for intraoperative localization of SLN. Validation studies with bigger patient cohorts are needed to prove our results.
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