近红外二区荧光导航手术在足踝外科中的应用初探

工程（英文） ›› 2024, Vol. 40 ›› Issue (9) : 20 -29. DOI: 10.1016/j.eng.2024.04.011

研究论文

樊潇霄 ^a^,^b ,
杨杰 ^c ,
倪沪桅 ^b ,
夏启铭 ^a ,
刘孝龙 ^a ,
吴天翔 ^b ,
李霖 ^c ,
Paras N. Prasad ^d ,
刘超 ^c^,^* ,
林辉 ^a^,^e^,^f^,^* ,
钱骏 ^a^,^b^,^*

作者信息 +

Initial Experience of NIR-II Fluorescence Imaging-Guided Surgery in Foot and Ankle Surgery

Xiaoxiao Fan ^a^,^b^,^# ,
Jie Yang ^c^,^# ,
Huwei Ni ^b^,^# ,
Qiming Xia ^a ,
Xiaolong Liu ^a ,
Tianxiang Wu ^b ,
Lin Li ^c ,
Paras N. Prasad ^d ,
Chao Liu ^c^,^* ,
Hui Lin ^a^,^e^,^f^,^* ,
Jun Qian ^a^,^b^,^*

Author information +

^aDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

^bCentre for Optical and Electromagnetic Research & International Research Center for Advanced Photonics, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310058, China

^cDepartment of Orthopedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

^dInstitute for Lasers, Photonics, and Biophotonics, Department of Chemistry, State University of New York, Buffalo, NY 14260-3000, USA

^eZhejiang Engineering Research Center of Cognitive Healthcare, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

^fCollege of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China

^aDepartment of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

^bCentre for Optical and Electromagnetic Research & International Research Center for Advanced Photonics, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310058, China

^cDepartment of Orthopedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

^dInstitute for Lasers, Photonics, and Biophotonics, Department of Chemistry, State University of New York, Buffalo, NY 14260-3000, USA

^eZhejiang Engineering Research Center of Cognitive Healthcare, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

^fCollege of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China

liuchaozju@zju.edu.cn (C. Liu),

369369@zju.edu.cn (H. Lin),

qianjun@zju.edu.cn (J. Qian)..

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文章历史 +

Received	Accepted	Published
2024-01-19	2024-04-14
Issue Date
2024-11-11

PDF (9997K)

摘要

近红外二区（NIR-II; 900~1880 nm）窗口的光学成像，是目前生物医学成像领域的热门研究课题。本研究旨在探索 NIR-II荧光成像在足踝外科手术中的应用价值。我们开发了一套实验室自建的NIR-II荧光手术导航系统，并将其用于足踝外科手术导航。相比于近红外一区（NIR-I）荧光图像，该系统获得的NIR-II荧光图像，拥有更高空间频率的信息以及更高的信号背景比（SBR）。本文的研究结果表明，NIR-II成像可为外科医生提供对比度更高、探测深度更大的图像。本研究纳入了三种临床应用场景（糖尿病足、跟骨骨折以及下肢创伤）。利用NIR-II荧光成像技术，我们在糖尿病足出现形态学改变前就观察到了缺血区域，精准定位了手术切口中缺血区域的边界，并全面评估了皮瓣的血供情况。NIR-II荧光成像能够帮助外科医生精确判断手术切缘，提早发现缺血性病变，并动态追踪灌注过程。我们认为，便携且可靠的NIR-II荧光成像设备以及更多功能性荧光探针，可在精准手术中发挥关键作用。

Abstract

Optical imaging in the second near-infrared (NIR-II; 900-1880 nm) window is currently a popular research topic in the field of biomedical imaging. This study aimed to explore the application value of NIR-II fluorescence imaging in foot and ankle surgeries. A lab-established NIR-II fluorescence surgical navigation system was developed and used to navigate foot and ankle surgeries which enabled obtaining more high-spatial-frequency information and a higher signal-to-background ratio (SBR) in NIR-II fluorescence images compared to NIR-I fluorescence images; our result demonstrates that NIR-II imaging could provide higher-contrast and larger-depth images to surgeons. Three types of clinical application scenarios (diabetic foot, calcaneal fracture, and lower extremity trauma) were included in this study. Using the NIR-II fluorescence imaging technique, we observed the ischemic region in the diabetic foot before morphological alterations, accurately determined the boundary of the ischemic region in the surgical incision, and fully assessed the blood supply condition of the flap. NIR-II fluorescence imaging can help surgeons precisely judge surgical margins, detect ischemic lesions early, and dynamically trace the perfusion process. We believe that portable and reliable NIR-II fluorescence imaging equipment and additional functional fluorescent probes can play crucial roles in precision surgery.