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Open Access Green as soon as Postprint is submitted to ZB.
Near-infrared fluorescence cholangiopancreatoscopy: Initial clinical feasibility results.
Gastrointest. Endosc. 79, 664–668 (2014)
BACKGROUND: The recent clinical propagation of targeted fluorescence agents brings a promising alternative in endoscopy by complementing visual disease detection with molecular biomarkers. OBJECTIVE: Development of near-infrared (NIR) fluorescence cholangiopancreatoscopy in real-time and validation of its clinical use. DESIGN: Feasibility study. SETTING: Tertiary referral center at a large university hospital. PATIENTS: Patients with pancreatic and biliary diseases. INTERVENTIONS: Routine cholangiopancreatoscopy with additional wide-field NIR fluorescence imaging. MAIN OUTCOME MEASUREMENTS: We adapted a miniature cholangioscope for real-time concurrent wide-field color and NIR fluorescence imaging. Illumination is provided through a custom-designed fiber bundle, and the acquired images are relayed via a dichroic beam splitter to 2 charge-coupled devices for simultaneous measurement. We characterize the sensitivity and resolution and demonstrate the clinical feasibility by detecting indocyanine green localization in 2 patients. RESULTS: A spatial optical resolution of approximately 50 μm was achieved, and fluorescent dye concentrations of 17.3 nM could be detected. Elevated fluorescence signals were detected during clinical measurements, and biopsy specimens confirmed the presence of malignancy in both patients. LIMITATIONS: Feasibility study, limited number of patients. CONCLUSIONS: The results demonstrate that real-time wide-field fluorescence detection in the NIR range is possible in humans by using adapted endoscopes. The feasibility of detecting indocyanine green in the pancreatobiliary ducts is verified, suggesting that cancer screening at a molecular level might play an increasingly important role in the future.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
ICG; IPMN; NIR; indocyanine green; intraductal papillary mucinous neoplasm; near-infrared; Bile-duct Cancer; Biliary Strictures; Indocyanine Green; Cholangioscopy; Diagnosis; Lesions; Tract; Ercp
ISSN (print) / ISBN
0016-5107
e-ISSN
1097-6779
Journal
Gastrointestinal Endoscopy
Quellenangaben
Volume: 79,
Issue: 4,
Pages: 664–668
Publisher
Elsevier
Publishing Place
New York
Reviewing status
Peer reviewed
Institute(s)
Institute of Biological and Medical Imaging (IBMI)