Toward (Hybrid) Navigation of a Fluorescence Camera in an Open Surgery Setting.

Abstract

CONCLUSION

This study reveals the potential benefits of FC navigation during open surgery procedures.

UNLABELLED

With the introduction of the hybrid tracer indocyanine green (ICG)-^99mTc-nanocolloid, a direct relation between preoperative imaging and intraoperative fluorescence guidance was established. However, fluorescence guidance remains limited by its superficial nature. This study evaluated the feasibility of a nuclear medicine-based navigation concept that allowed intraoperative positioning of a fluorescence camera (FC) in the vicinity of preoperatively defined ICG-^99mTc-nanocolloid containing sentinel nodes (SNs).

METHODS

Five patients with penile cancer scheduled for SN biopsy were injected with ICG-^99mTc-nanocolloid followed by preoperative SPECT/CT imaging. The navigation device was used to provide a real-time augmented reality overlay of the SPECT/CT images and video output of the FC. This overlay was then used for FC navigation.

RESULTS

SPECT/CT identified 13 SNs in 9 groins. FC navigation was successful for all 12 intraoperatively evaluated SNs (average error, 8.8 mm; range, 0-20 mm).