22 December 2017 Development and evaluation of a connective tissue phantom model for subsurface visualization of cancers requiring wide local excision
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Abstract
Wide local excision (WLE) of tumors with negative margins remains a challenge because surgeons cannot directly visualize the mass. Fluorescence-guided surgery (FGS) may improve surgical accuracy; however, conventional methods with direct surface tumor visualization are not immediately applicable, and properties of tissues surrounding the cancer must be considered. We developed a phantom model for sarcoma resection with the near-infrared fluorophore IRDye 800CW and used it to iteratively define the properties of connective tissues that typically surround sarcoma tumors. We then tested the ability of a blinded surgeon to resect fluorescent tumor-simulating inclusions with 1 - cm margins using predetermined target fluorescence intensities and a Solaris open-air fluorescence imaging system. In connective tissue-simulating phantoms, fluorescence intensity decreased with increasing blood concentration and increased with increasing intralipid concentrations. Fluorescent inclusions could be resolved at 1 - cm depth in all inclusion concentrations and sizes tested. When inclusion depth was held constant, fluorescence intensity decreased with decreasing volume. Using targeted fluorescence intensities, a blinded surgeon was able to successfully excise inclusions with 1 - cm margins from fat- and muscle-simulating phantoms with inclusion-to-background contrast ratios as low as 2 1 . Indirect, subsurface FGS is a promising tool for surgical resection of cancers requiring WLE.
© 2017 Society of Photo-Optical Instrumentation Engineers (SPIE)
Kimberley S. Samkoe, Brent D. Bates, Niki N. Tselepidakis, Alisha V. DSouza, Jason R. Gunn, Dipak B. Ramkumar, Keith D. Paulsen, Brian W. Pogue, Eric R. Henderson, "Development and evaluation of a connective tissue phantom model for subsurface visualization of cancers requiring wide local excision," Journal of Biomedical Optics 22(12), 121613 (22 December 2017). https://doi.org/10.1117/1.JBO.22.12.121613 . Submission: Received: 21 April 2017; Accepted: 1 December 2017
Received: 21 April 2017; Accepted: 1 December 2017; Published: 22 December 2017
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