Green Fluorescence Imaging Research Articles

Fluorescence Imaging-Guided Identification of Thymic Masses Using Low-Dose Indocyanine Green.

Indocyanine green (ICG) fluorescence imaging has been used to detect many types of tumors during surgery; however, there are few studies on thymic masses and the dose and time of ICG injection have not been optimized. We aimed to evaluate the optimal ICG injection dose and timing for detecting thymic masses during surgery. Forty-nine consecutive patients diagnosed with thymic masses on preoperative computed tomography (CT) and scheduled to undergo thymic cystectomy or thymectomy were included. Patients were administered 1, 2, or 5mg/kg of ICG at different times. Thymic masses were observed during and after surgery using a near-infrared fluorescence imaging system, and the fluorescence signal tumor-to-normal ratio (TNR) was analyzed. Among the 49 patients, 14 patients with thymic cysts showed negative fluorescence signals, 33 patients with thymoma or thymic carcinoma showed positive fluorescence signals, and 2 patients showed insufficient fluorescence signals. The diagnosis of thymic masses based on CT was correct in 32 (65%) of 49 cases; however, the differential diagnosis of thymic masses based on NIR signals was correct in 47 of 49 cases (96%), including 14 cases of thymic cysts (100%) and 33 cases of thymomas or thymic carcinomas (94%). In addition, TNR was not affected by the time or dose of ICG injection, histological type, stage, or tumor size. Low-dose intravenous injection of ICG at flexible time can detect thymic tumors. In addition, thymic cysts can be distinguished from thymomas or thymic carcinomas during surgery by the absence of ICG fluorescence signals.

Near-infrared fluorescence imaging with indocyanine green for assessment of donor livers in a rat model of ischemia\u2013reperfusion

BackgroundAlthough marginal donor livers expand the donor pool, an ideal method for quantitatively evaluating the quality of donor livers has not been developed. This study aimed to explore the feasibility of indocyanine green (ICG) fluorescence imaging for estimating liver function in an ischemia–reperfusion model.MethodsForty-eight rats were randomly and evenly divided into 8 groups: the control group and the experimental groups (I-VII). The portal vein blocking period was 0 min, 10 min, 20 min, 30 min, 40 min, 50 min and 60 min. After blood flow was reestablished and the hemodynamics stabilized, ICG was injected through the dorsal penile vein as a bolus, and the fluorescence signal was recorded for 30 min in real time. The fluorescence intensity (FI) curve of the liver was fitted with an asymptotic regression model. Fresh liver tissues and serum were obtained from the middle lobe of the liver on postoperative day (POD) 1 and POD 7 for histopathological evaluation and liver function tests.ResultsThe growth rate of the FI curve, parameter b3, decreased from groups I to VII. According to the two sudden changes in b3 (20 min, 50 min), the experimental groups could be classified into 3 groups (A, B and C). Hepatocytes in groups I-II showed slight edema, group III began to show obvious hepatocyte edema and vacuolar degeneration, and in groups VI-VII, severe hepatocyte degeneration, necrosis and large inflammatory cell infiltration were observed. Suzuki’s scores in the 3 groups were also significantly different (P < 0.01). At the same time, the serum liver function in the experimental groups showed a significant increase on POD 1 and a decrease on POD 7. The alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TB) levels of groups A, B, and C were significantly different on POD 1 (P < 0.05), and the ALT and direct bilirubin (DB) levels were significantly different on POD 7 (P < 0.05); the lactic dehydrogenase (LDH) level of the group C was significantly higher than that of the groups A and B on POD 1 and POD 7. Meanwhile, the 7-day survival rate of the rats in group C was poor compared to that of the rats in groups A and B (58.3% vs. 100% vs. 100%).ConclusionICG fluorescence imaging is effective for estimating the degree of liver damage and grading in an ischemia–reperfusion model. It probably has the potential for use in assessing the quality of the donor liver in liver transplantation.

469 ASSESSMENT OF PERFUSION OF GASTRIC CONDUIT AND PROXIMAL ESOPHAGEAL STUMP BY INDOCYANINE GREEN FLUORESCENCE IMAGING IN PATIENTS UNDERGOING ESOPHAGECTOMY

Abstract Post esophagectomy anastomotic leakage and stricture are crucial factors in determining morbidity and mortality. Good vascularity of the gastric conduit is essential to avoid this complications. This prospective study assesses the utility of intraoperative indocyanine green (ICG) fluorescence imaging to determine gastric conduit vascularity in patients undergoing esophagectomy. Methods Thirteen consecutive patients who were undergoing esophagectomy for carcinoma middle, lower third esophagus or gastro-esophageal junction from August 2019 to September 2019, were included. Three patients underwent laparoscopic-assisted transhiatal esophagectomy, ten thoraco-laparoscopic assisted esophagectomy. Reconstruction was done by gastric pull up via posterior mediastinal route. Vascularity of gastric conduit was assessed by the near-infrared camera using ICG. Results On visual assessment of perfusion at the tip of gastric conduit, it was dusky in 11 patients, pink in two. Fuorescence imaging showed inadequate perfusion at the tip of conduit in 12 patients, needing revision. In one patient visual inspection showed adequate perfusion, but ICG disclosed poor vascularity requiring revision of the conduit’s tip. Resection of the devitalized portion of the proximal esophageal stump was needed in 5 patients both by visual and ICG assessment. The median time to appearance of blush from the time of injection of dye was 15 seconds (10 to 23 seconds). Conclusion Visual inspection of the gastric conduit vascularity can underestimate perfusion and hence can compromise resection of the devitalized part. ICG fluorescence imaging is more objective and promising means to ascertain the vascularity of gastric conduit during an esophagectomy. It could complement the visual inspection to decide the site of anastomosis.

A High-Resolution Microfluidic LAPS Imaging System for 3D Cell Metabolism Monitoring

A High-Resolution Microfluidic LAPS Imaging System for 3D Cell Metabolism Monitoring

The application of indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging for assessment of the lymphatic system in reconstructive lymphaticovenular anastomosis surgery

ABSTRACT Introduction Lymphedema has traditionally been managed through noninvasive means with complete decongestive therapy. However, complete decongestive therapy is an intensive program that requires lifelong adherence by patients with lymphedema. More recently, reconstructive surgical procedures have shown promise in improving lymphedema by physiologically restoring lymphatic function. One of these types of procedures, lymphaticovenular anastomosis, relies on technological advances in imaging, particularly indocyanine green lymphangiography. Areas covered This article reviews indocyanine green and near-infrared fluorescence imaging. In addition, this article discusses the application of this imaging to the preoperative, intraoperative, and postoperative assessment of the lymphatic system in the setting of lymphaticovenular anastomosis surgery. Expert opinion Indocyanine green lymphangiography offers significant advantages over other types of imaging of the lymphatic system. In the future, it is hopeful that additional options for these imaging devices will become available which may increase their accessibility by centers interested in performing reconstructive lymphatic surgery, including in relation to cost. Finally, more studies with higher levels of evidence are needed to better define the long-term outcomes associated with lymphatic surgery including LVA. In this regard, practitioners should fully harness the information conferred by ICG lymphangiography as both a clinical and research tool.

Handheld Near-Infrared Fluorescence Imaging Device Using Modified Action Cameras for Peri-Operative Guidance of Microvascular Flap Surgery.

Indocyanine green near-infrared fluorescence (ICG-NIRF) imaging has recently come into use as a novel method in peri-operative microvascular flap assessment. However, a majority of the many commercial devices launched for clinical use lack mobility, portability, and cost-efficiency and are thus unsuitable for intra-oral applications. This study introduces a cost-effective, customized, handheld NIRF device following principles of ICG-NIRF imaging. Moreover, the novel characteristics of our prototype, considered in conjunction with a literature review highlighting the significance of fluorescence devices in microvascular surgery, point to a new generation of devices for use in microvascular flap surgery.

Green Fluorescence Imaging (ICG) for the Study of Lymphatic Drainage in Pancreatic Head Tumors

Green Fluorescence Imaging (ICG) for the Study of Lymphatic Drainage in Pancreatic Head Tumors

Retrospective review of sentinel lymph node mapping in endometrial cancer using indocyanine green and near infra-red fluorescence imaging during minimally invasive surgery

Retrospective review of sentinel lymph node mapping in endometrial cancer using indocyanine green and near infra-red fluorescence imaging during minimally invasive surgery

Design of Catechin-based Carbon Nanodots as Facile Staining Agents of Tumor Cells

Carbon nanodots (CNDs) have widely received great attention as a result of favorable optical, electrical, optoelectrical, biocompatible, and non-toxic properties these nanoparticles possess. However, the exploration of nanoparticle from natural raw material was limited. In present work, the carbon dots were produced from catechin isolated from Uncaria gambir through a simple and facile process. Carbon nanodots were further produced by the pyrolysis process of catechin, which allowed it for carbonization. Owing to its unique properties such as photoluminescence with an emission peak at 500 nm (lex = 380 nm), average size diameter about 5 nm and non-toxic; Cat-CNDs were incredibly potential for staining targeted tumor cells. The staining ability by confocal microscopy observations showed their green fluorescence images which meant that the CNDs easily penetrated HeLa cells via endocytosis. The resulting CNDs which were analyzed using some significant techniques approved that the prepared Cat-CNDs were tremendously dispersible and water-soluble, good colloidal stability, excellent biocompatibility, favorable hydrophilicity, high photostability, and non-toxicity.

Intelligent Drug Delivery Microparticles with Visual Stimuli-Responsive Structural Color Changes.

BackgroundParticle-based drug delivery systems (DDSs) have a demonstrated value for drug discovery and development. However, some problems remain to be solved, such as limited stimuli, visual-monitoring.AimTo develop an intelligent multicolor DDSs with both near-infrared (NIR) controlled release and macroscopic color changes.Materials and MethodsMicroparticles comprising GO/pNIPAM/PEGDA composite hydrogel inverse opal scaffolds, with dextran and calcium alginate hydrogel were synthesized using SCCBs as the template. The morphology of microparticle was observed under scanning electron microscopy, and FITC-dextran-derived green fluorescence images were determined using a confocal laser scanning microscope. During the drug release, FITC-dextran-derived green fluorescence images were captured using fluorescent inverted microscope. The relationship between the power of NIR and the drug release rate was obtained using the change in optical density (OD) values. Finally, the amount of drug released could be estimated quantitatively used the structural color or the reflection peak position.ResultsA fixed concentration 8% (v/v) of PEGDA and 4mg/mL of GO was chosen as the optimal concentration based on the balance between appropriate volume shrinkage and structure color. The FITC-dextran was uniformly encapsulated in the particles by using 0.2 wt% sodium alginate. The microcarriers shrank because of the photothermal response and the intrinsic fluorescence intensity of FITC-dextran in the microparticles gradually decreased at the same time, indicating drug release. With an increasing duration of NIR irradiation, the microparticles gradually shrank, the reflection peak shifted toward blue and the structural color changed from red to orange, yellow, green, cyan, and blue successively. The drug release quantity can be predicted by the structural color of microparticles.ConclusionThe multicolor microparticles have great potential in drug delivery systems because of its vivid reporting color, excellent photothermal effect, and the good stimuli responsivity.

Angiotensin II Type I Receptor Agonistic Autoantibody Blockade Improves Cerebral Blood Flow Autoregulation, Blood Brain Barrier Permeability, and Hypertension in the Pre‐Clinical Rat Model of Preeclampsia

BackgroundPreeclampsia (PE) is a pregnancy disorder that is characterized by an increase in blood pressure, angiotensin II type1 receptor agonistic autoantibodies (AT1‐AA), and neurological complications. The pre‐clinical RUPP (reduced uterine perfusion pressure) rat model of PE displays many of the clinical pathologies associated with PE, such as increased blood pressure, AT1‐AAs, blood brain barrier (BBB) permeability, and impaired cerebral blood flow (CBF) autoregulation.HypothesisWe hypothesized that specific inhibition of AT1‐AA, using the epitope binding 7 amino acid peptide sequence (7AA), will improve blood pressure, BBB integrity, and CBF autoregulation in RUPP rats.MethodsSprague Dawley rats, were divided into 3 groups: normal pregnant (NP) (n=19), RUPP (n=19), and RUPP+AT1‐AA inhibition (7AA) (n=21). RUPP surgery was performed on gestational day (GD) 14 and 7AA (2μg/μl) was administered via osmotic minipumps. GD 19, mean arterial pressure (MAP) was determined and BBB permeability was assessed using the in‐vivo imaging system (IVIS). CBF was measured by laser Doppler flowmetry through a 4 mm x 4 mm cranial window under anesthesia. MAP was elevated step‐wise from 100–190 mmHg by infusion of phenylephrine to determine changes in CBF.ResultsMAP was increased in RUPP vs NP (124±3 vs 100±1 mmHg, p&lt;0.05) and decreased in RUPP+7AA vs RUPP (105±2 vs 124±3 mmHg, p&lt;0.05) rats. Using IVIS, Texas Red/FITC green fluorescent imaging was decreased in RUPP+7AA vs RUPP (0.2±0.001 vs 0.6±0.001, p&lt;0.05), indicating improvement in BBB permeability with AT1‐AA inhibition. CBF autoregulation was impaired in RUPP vs NP rats at 140 mmHg (142±7 vs 119±4%, p&lt;0.05) and 160 mmHg (157±10 vs 129±6%, p&lt;0.05) (both pressures are within the normal CBF autoregulatory range). AT1‐AA inhibition prevented impaired CBF at 140mmHg (125±5 RUPP+7AA vs 142±7% RUPP, p&lt;0.05) and 160 mmHg (125±9 RUPP+7AA vs 157±10% RUPP, p&lt;0.05). Furthermore, the increases in CBF at pressures above the autoregulatory range, 180 mmHg (122±10 vs 198±17%, p&lt;0.05) and 190 mmHg (123±11 vs 208±19%, p&lt;0.05), was prevented in RUPP+7AA vs RUPP, respectively.ConclusionAT1‐AA inhibition improved blood pressure, BBB permeability, and CBF autoregulation in the pre‐clinical RUPP rat model of PE, indicating that AT1‐AA inhibition may be a potential therapy used to improve neurological complications during PE.Support or Funding InformationSupported: AHA18CDA34110264

Time course analysis of sensory axon regeneration in vivo by directly tracing regenerating axons.

Most current studies quantify axon regeneration by immunostaining regeneration-associated proteins, representing indirect measurement of axon lengths from both sensory neurons in the dorsal root ganglia and motor neurons in the spinal cord. Our recently developed method of in vivo electroporation of plasmid DNA encoding for enhanced green fluorescent protein into adult sensory neurons in the dorsal root ganglia provides a way to directly and specifically measure regenerating sensory axon lengths in whole-mount nerves. A mouse model of sciatic nerve compression was established by squeezing the sciatic nerve with tweezers. Plasmid DNA carrying enhanced green fluorescent protein was transfected by ipsilateral dorsal root ganglion electroporation 2 or 3 days before injury. Fluorescence distribution of dorsal root or sciatic nerve was observed by confocal microscopy. At 12 and 18 hours, and 1, 2, 3, 4, 5, and 6 days of injury, lengths of regenerated axons after sciatic nerve compression were measured using green fluorescence images. Apoptosis-related protein caspase-3 expression in dorsal root ganglia was determined by western blot assay. We found that in vivo electroporation did not affect caspase-3 expression in dorsal root ganglia. Dorsal root ganglia and sciatic nerves were successfully removed and subjected to a rapid tissue clearing technique. Neuronal soma in dorsal root ganglia expressing enhanced green fluorescent protein or fluorescent dye-labeled microRNAs were imaged after tissue clearing. The results facilitate direct time course analysis of peripheral nerve axon regeneration. This study was approved by the Institutional Animal Care and Use Committee of Guilin Medical University, China (approval No. GLMC201503010) on March 7, 2014.

Indocyanine Green (ICG) Fluorescence Imaging in Sentinel Lymph Node Biopsy (SLNB) for Early Breast Cancer: First Indian Experience

To explore the utility and safety of indocyanine green (ICG) for the fluorescence-guided detection of sentinel lymph nodes (SLNs) during sentinel lymph node biopsy (SLNB) in patients with early breast cancer. Patients diagnosed with early breast cancer with clinically negative axilla were involved in the study. ICG dye was injected as per protocol. Sentinel lymph node (SLN) was harvested and axillary clearance was done in all patients irrespective of SLN status. SLN identification rate, sensitivity, specificity, positive predictive value, negative predictive value and false negative rate were calculated. Forty patients were involved in the study, with most of the patients being in their fifth decade. Median BMI of patient was 24 (range 19–34). SLN was identified in all the patients, total of 110 nodes were detected, with mean being 2.75 (1–6). Seventeen of 40 patients had positive nodes on axilla, of which 16 were detected by SLN and one patient had isolated tumour cells which were detected on final grossing and histopathology report. The sensitivity, specificity, positive predictive value, negative predictive value and false negative rate were 94.1%, 100%, 100%, 95.8% and 5.8%, respectively. None of the patients had any complications with ICG injection. ICG-based fluorescence technique is easy and safe for SLNB in early breast cancer and is ready for clinical application. A well-designed study comparing the standard dual dye technique with ICG needs to be done to explore if it can replace the existing standard.

Penetration model for chemical reactivation for resin-embedded green fluorescent protein imaging.

.In the so-called surface microscopy, serial block-face imaging is combined with mechanic sectioning to obtain volumetric imaging. While mapping a resin-embedded green fluorescent protein (GFP)-labeled specimen, it has been recently reported that an alkaline buffer is used to chemically reactivate the protonated GFP molecules, and thus improve the signal-to-noise ratio. In such a procedure, the image quality is highly affected by the penetration rate of a solution. We propose a reliable penetration model to describe the penetration process of the solution into the resin. The experimental results are consistent with the parameters predicted using this model. Thus, this model provides a valuable theoretical explanation and aids in optimizing the system parameters for mapping resin-embedded GFP biological samples.

PS01.193: VISUALIZED EVALUATION OF BLOOD FLOW TO THE GASTRIC CONDUIT CONTRIBUTES TO REDUCTION OF COMPLICATION IN ESOPHAGEAL RECONSTRUCTION

Abstract Background Evaluation of the blood supply to gastric conduits is critically important to avoid complications following esophagectomy. We commenced visualized evaluation of blood flow using indocyanine green (ICG) fluorescent imaging from July 2015, to reduce reconstructive complications. In this study, we aimed to statistically verify the efficacy of blood flow evaluation using our simplified ICG method. Methods We analysed and compared two groups, those before and after introduction of ICG evaluation. We performed propensity score matching (PS-M), compared clinical outcomes and analysed how the visualized evaluation reduced the risk of complications. Results Sixty-eight matched pairs were analysed. The leakage rate in the ICG group was significantly lower than the non-ICG group for each severity grade both in the entire cohort (285 subjects) and after PS-M, while the rate of other major complications, including recurrent laryngeal nerve (RLN) palsy and pneumonia, were not different between the two groups in the entire cohort and after PS-M. The duration of postoperative intensive care unit (ICU) stay was approximately one day shorter in the ICG than the non-ICG group in the entire cohort, and approximately two days shorter after PS-M. Visualized evaluation of blood flow with ICG methods significantly reduced the rate of anastomotic complications of all Clavien-Dindo (CD) severity grades. Odds ratio with ICG evaluation decreased with CD grade (0.3419 for CD ≥ 1, 0.241 for CD ≥ 2 and 0.2153 for CD ≥ 3). Conclusion Objective evaluation of blood supply to the reconstructed conduit using ICG fluorescent imaging reduces the risk and degree of anastomotic complication. Disclosure All authors have declared no conflicts of interest.

PS01.206: ASSESSMENT OF THE GASTRIC CONDUIT RECONSTRUCTION USING INDOCYANINE GREEN FLUORESCENT IMAGING DURING ESOPHAGECTOMY

Abstract Background Recently, indocyanine green (ICG) fluorescent imaging has been applied as a real-time navigation tool in various surgical fields. We used ICG fluorescent imaging for gastric conduit reconstruction during esophagectomy. Methods A total of 92 consecutive patients with esophageal cancer who received gastric conduit reconstruction during esophagectomy from February 2011 to December 2017 were enrolled in the present study. We made gastric conduit with hand-assisted laparoscopic surgery (HALS) following esophagectomy. A gastric conduit with a width of 3cm was usually fashioned. After evaluation of the blood flow to the gastric conduit using ICG fluorescent imaging, anastomosis was done by circular stapler. Results The study group was comprised of 73 males and 19 females and the median age was 70 years (range 54–85 years). Nineteen patients received preoperative chemotherapy and eleven patients received preoperative chemo-radiotherapy. Forty-eight patients underwent thoracoscopic esophagectomy, nineteen patients underwent thoracotomy and twenty-five patients underwent laparoscope assisted transhiatal esophagectomy. In eighty-five patients, reconstruction was done via the posterior mediastinal route, while six patients ware treated by the retrosternal route, and the subcutaneous route was used in one patient. Cervical anastomosis was done in 84 patients and intrathoracic anastomosis was done in eight patients. The complications of the gastric conduit reconstruction were anastomotic leakage in one (1.1%) patient and stricture of the anastomosis site requiring esophageal dilatation in 26 (28.3%) patients. Periodic esophageal dilatation was done in 13 (14.1%) patients. There was one case of stricture of the gastric conduit, one case of bleeding of the gastric conduit and one case of fistula between the gastric conduit and the lung. Conclusion The gastric conduit reconstruction using ICG fluorescent imaging during esophagectomy may contribute to a reduction in the incidence of anastomotic leakage. However, further advancement of the relevant skills is required to improve the incidence of stricture of the anastomosis site. Disclosure All authors have declared no conflicts of interest.

PS02.076: VISUALIZATION OF BLOOD SUPPLY ROUTE TO THE RECONSTRUCTED STOMACH BY INDOCYANINE GREEN FLUORESCENCE IMAGING DURING ESOPHAGECTOMY, 2ND REPORT

Abstract Background Recently, indocyanine green (ICG) fluorescence imaging has been used to visualize the blood supply when anastomosis is performed in vascular surgery. We have reported the three blood supply routes to the reconstructed stomach using ICG fluorescence imaging for reconstruction during esophagectomy. Blood flow routes in the 33 patients with esophageal cancer were classified into categories on the basis of ICG imaging findings: the gastric wall route, the greater curvature route, and the omentum and splenic hiatal route. The gastric wall route was found in 13 patients and characterized by large blood vessels in the gastric wall. The greater curvature route was present in 11 patients and characterized by blood vessels in the greater omentum. The omentum and beside splenic hilum route was found in 22 patients. Blood vessels ran in the greater omentum beside the splenic hilum. a photodynamic eye (PDE) showed blood flow from right gastroepiploic artery, omentum vessels, left gastroepiploic artery, splenic hiatal vessels, short gastric artery, and gastric wall vessels to the top of the reconstructed stomach. The ‘splenic hiatal route’ was present in 66.7% of the patients and was formed by large vessels or networks of small vessels. We rechecked the ‘splenic hiatal route’ cases and recognize that the branch parted from the right gastroepiploic artery. We tried preservation of the ‘splenic hiatal route’. Methods Since January 2017, we have preserved the ‘splenic hiatal route’ and performed ICG fluorescence imaging in 5 patients with thoracic esophageal cancer who underwent thoracic esophagectomy. After pulling up the reconstructed stomach, 2.5 mg of ICG was injected as a bolus. ICG fluorescence imaging was performed with a near-infrared camera, and the images were recorded. Results ICG fluorescence was easily detected in all patients 1 min after injection. Vascular networks were well visualized in the gastric wall and omentum. The blood supply route was visualized the ‘splenic hiatal route’ in all patients. Conclusion On ICG fluorescence imaging, the splenic hiatal vessels would be the major blood supply for the anastomosis in most patients. Disclosure All authors have declared no conflicts of interest.

PS02.069: CERVICAL GASTROPLASTY ANASTOMOSIS AFTER ESOPHAGECTOMY: INDOCYANINE GREEN FLUORESCENCE IMAGING EVALUATION AND TECHNICAL SURGICAL ASPECTS

Abstract Description One of the most frequent complication after esophagectomy is the anastomotic leakage, which is a determiming factor of morbidity and mortality after surgical treatment. The best location for the esophagogastric anastomosis (cervical or intra-thoracic) has been topic of discussion for many years, and surgical aspects as resected margins, recurrent nerve trauma and mainly the vascularization of the anastomosis. In this video we performed a cervical gastroplasty anastomosis (McKeown), side-to-side, stapled (linear stapler) with a thin gastric tube conduit, and after that we aimed to determine the feasibility and usefulness of indocyanine green (ICG) fluorescence imaging to evaluate the gastric conduit perfusion during an esophagectomy. After pulling up the gastric conduit trhought the mediastinum and after performing the cervical anastomosis, 5 mg of ICG was in jected as a bolus and visual assessment of the blood supply of the gastric conduit was seen. This patient was a 63 years old, male, with adenocarcinoma of esophago-gastric junction (Siewert II) underwent to neoadjuvant quimiotherapy (FOLFOX regimen) and submitted after 3 cycles to esophagectomy (thoracoscopy and laparoscopy). No fistula was found in post operative follow-up, and either complications. Disclosure All authors have declared no conflicts of interest.

Background Modeling Method to Identify Interactions Between Circulating Tumor Cells and Dendritic Cells.

Interactions between dendritic cells (DCs) and circulating tumor cells (CTCs) have attracted wide attention in tumor immunity research, especially on specifically targeted tumors. However, feature extraction and noninvasive tracking of DCs and CTCs are challenges that have long existed in biomedicine. In this study, we developed an automatic algorithm for identifying, counting, tracking, and segmenting fluorescently-labeled CTCs and DCs from the blood vessels of mouse ears. For fluorescence imaging, we constructed an in vivo image flow cytometry system to capture dual-channel (green and red) fluorescence image sequence simultaneously. To achieve real-time functions for the CTCs and DCs, we developed a motion detection method based on codebook which first performs background modeling and then cone-shaped area search procedures for postprocessing. We validated this novel algorithm through in vivo image sequencing, through which we observed the interaction of CTCs and DCs. Moreover, we used quantitative colocalization to determine the relationship between CTCs and DCs. The quantitative results illustrated the interactions between CTCs and DCs, as did image sequences which are promising for driving research on cancer immunotherapy in the future.

Prospective validation of sentinel lymph node (SLN) biopsy with indocyanine green (ICG) fluorescence imaging in high-risk endometrial cancer

Prospective validation of sentinel lymph node (SLN) biopsy with indocyanine green (ICG) fluorescence imaging in high-risk endometrial cancer