The FLARE™ Intraoperative Near-Infrared Fluorescence Imaging System: A First-in-Human Clinical Trial in Breast Cancer Sentinel Lymph Node Mapping
By S. Troyan, V. Kianzad, S. Gibbs-Strauss, S. Gioux, Aya Matsui, R. Oketokoun, L. Ngo, A. Khamene, F. Azar, John V. Frangioni. Annals of Surgical Oncology, 2009
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BackgroundInvisible NIR fluorescent light can provide high sensitivity, high-resolution, and real-time image-guidance during oncologic surgery, but imaging systems that are presently available do not display this invisible light in the context of surgical anatomy. The FLARE™ imaging system overcomes this major obstacle.MethodsColor video was acquired simultaneously, and in real-time, along with two independent channels of NIR fluorescence. Grayscale NIR fluorescence images were converted to visible “pseudo-colors” and overlaid onto the color video image. Yorkshire pigs weighing 35 kg (n = 5) were used for final preclinical validation of the imaging system. A six-patient pilot study was conducted in women undergoing sentinel lymph node (SLN) mapping for breast cancer. Subjects received 99mTc-sulfur colloid lymphoscintigraphy. In addition, 12.5 μg of indocyanine green (ICG) diluted in human serum albumin (HSA) was used as an NIR fluorescent lymphatic tracer.ResultsThe FLARE™ system permitted facile positioning in the operating room. NIR light did not change the look of the surgical field. Simultaneous pan-lymphatic and SLN mapping was demonstrated in swine using clinically available NIR fluorophores and the dual NIR capabilities of the system. In the pilot clinical trial, a total of nine SLNs were identified by 99mTc- lymphoscintigraphy and nine SLNs were identified by NIR fluorescence, although results differed in two patients. No adverse events were encountered.ConclusionsWe describe the successful clinical translation of a new NIR fluorescence imaging system for image-guided oncologic surgery.
Subfields: Biomedical Engineering, Oncology, Surgery
View Paper: https://www.semanticscholar.org/paper/c6f3911ee68a29ea99b1dfaaeee270d219f753be
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In Biomedical Engineering
Citations in the corpus
- The clinical use of indocyanine green as a near-infrared fluorescent contrast agent for image-guided oncologic surgery (2011, methodology): “Several others imaging systems have been used in clinical studies but are not commercially available: HyperEye [2] (Kochi Medical School, Kochi, Japan), the FLARE and Mini-FLARE [3] (Beth Israel Deaconess Hospital, Boston, MA, USA), the FDPM imager [35] (Texas Medical Center, Houston, TX), and a pro”