Development of a handheld fluorescence imaging camera for intraoperative sentinel lymph node mapping.

Lukasz Szyc,Dirk Grosenick,Alfred Walter,Uwe Jagemann,Rainer Macdonald,Stefanie Bonifer

doi:10.1117/1.jbo.20.5.051025

Lukasz Szyc, Dirk Grosenick + Show 4 more

Open Access

https://doi.org/10.1117/1.jbo.20.5.051025

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Abstract

We present a compact fluorescence imaging system developed for real-time sentinel lymph node mapping. The device uses two near-infrared wavelengths to record fluorescence and anatomical images with a single charge-coupled device camera. Experiments on lymph node and tissue phantoms confirmed that the amount of dye in superficial lymph nodes can be better estimated due to the absorption correction procedure integrated in our device. Because of the camera head's small size and low weight, all accessible regions of tissue can be reached without the need for any adjustments.

Highlights

For more than a century, lymphadenectomy, the elective radical removal of regional lymph nodes, has been a standard approach in cancer surgery
To minimize the risk of unnecessary lymph node rejection for patients without metastasis, surgeons search for so-called sentinel lymph nodes (SLNs), which drain the lymph from the tumor area first
We present a novel, handheld, low-cost device developed for intraoperative fluorescence imaging of SLN applying indocyanine green (ICG) as a contrast agent (Fig. 1)

Summary

Introduction

For more than a century, lymphadenectomy, the elective radical removal of regional lymph nodes, has been a standard approach in cancer surgery. The likelihood of complications, among others lymphocele, thrombosis, embolism, or lymphedema increases with the number of removed lymph nodes and glands. To minimize the risk of unnecessary lymph node rejection for patients without metastasis, surgeons search for so-called sentinel lymph nodes (SLNs), which drain the lymph from the tumor area first. The SLN is located, removed, and examined for cancer cells. If the sentinel nodes are not affected, there is a very high probability that the peripheral lymph nodes are free of cancer cells and their removal is superfluous. If cancer cells are found in the sentinel node, the entire affected lymphatic tissue is removed

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