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

Xiaoxiao Fan; Jie Yang; Huwei Ni; Qiming Xia; Xiaolong Liu; Tianxiang Wu; Lin Li; Paras N. Prasad; Chao Liu; Hui Lin; Jun Qian

doi:10.1016/j.eng.2024.04.011

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Engineering ›› 2024, Vol. 40 ›› Issue (9) : 19-27. DOI: 10.1016/j.eng.2024.04.011

Research

Article

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^,^*

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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.

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Keywords

Second near-infrared fluorescence imaging / Foot and ankle surgery / Indocyanine green / Imaging-guided surgery

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Xiaoxiao Fan, Jie Yang, Huwei Ni, Qiming Xia, Xiaolong Liu, Tianxiang Wu, Lin Li, Paras N. Prasad, Chao Liu, Hui Lin, Jun Qian. Initial Experience of NIR-II Fluorescence Imaging-Guided Surgery in Foot and Ankle Surgery. Engineering, 2024, 40(9): 19‒27 https://doi.org/10.1016/j.eng.2024.04.011

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