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
Affiliations
Xiaoxiao Fan
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; Centre for Optical and Electromagnetic Research & International Research Center for Advanced Photonics, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310058, China
Jie Yang
Department of Orthopedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
Huwei Ni
Centre for Optical and Electromagnetic Research & International Research Center for Advanced Photonics, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310058, China
Qiming Xia
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
Xiaolong Liu
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
Tianxiang Wu
Centre for Optical and Electromagnetic Research & International Research Center for Advanced Photonics, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310058, China
Lin Li
Department of Orthopedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
Paras N. Prasad
Institute for Lasers, Photonics, and Biophotonics, Department of Chemistry, State University of New York, Buffalo, NY 14260-3000, USA
Chao Liu
Department of Orthopedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; Corresponding authors.
Hui Lin
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; Zhejiang Engineering Research Center of Cognitive Healthcare, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou 310027, China; Corresponding authors.
Jun Qian
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; Centre for Optical and Electromagnetic Research & International Research Center for Advanced Photonics, College of Optical Science and Engineering, Zhejiang University, Hangzhou 310058, China; Corresponding authors.
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.
