Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Identifieur interne : 000375 ( Pmc/Curation ); précédent : 000374; suivant : 000376Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Auteurs : Lucia M. A. Crane ; George Themelis ; K. Tim Buddingh ; Niels J. Harlaar ; Rick G. Pleijhuis ; Athanasios Sarantopoulos ; Ate G. J. Van Der Zee ; Vasilis Ntziachristos ; Gooitzen M. Van DamSource :
- Journal of Visualized Experiments : JoVE [ 1940-087X ] ; 2010.
Abstract
The prognosis in virtually all solid tumors depends on the presence or absence of lymph node metastases.1-3 Surgical treatment most often combines radical excision of the tumor with a full lymphadenectomy in the drainage area of the tumor. However, removal of lymph nodes is associated with increased morbidity due to infection, wound breakdown and lymphedema.4,5 As an alternative, the sentinel lymph node procedure (SLN) was developed several decades ago to detect the first draining lymph node from the tumor.6 In case of lymphogenic dissemination, the SLN is the first lymph node that is affected (Figure 1). Hence, if the SLN does not contain metastases, downstream lymph nodes will also be free from tumor metastases and need not to be removed. The SLN procedure is part of the treatment for many tumor types, like breast cancer and melanoma, but also for cancer of the vulva and cervix.7 The current standard methodology for SLN-detection is by peritumoral injection of radiocolloid one day prior to surgery, and a colored dye intraoperatively. Disadvantages of the procedure in cervical and vulvar cancer are multiple injections in the genital area, leading to increased psychological distress for the patient, and the use of radioactive colloid.
Multispectral fluorescence imaging is an emerging imaging modality that can be applied intraoperatively without the need for injection of radiocolloid. For intraoperative fluorescence imaging, two components are needed: a fluorescent agent and a quantitative optical system for intraoperative imaging. As a fluorophore we have used indocyanine green (ICG). ICG has been used for many decades to assess cardiac function, cerebral perfusion and liver perfusion.8 It is an inert drug with a safe pharmaco-biological profile. When excited at around 750 nm, it emits light in the near-infrared spectrum around 800 nm. A custom-made multispectral fluorescence imaging camera system was used.9.
The aim of this video article is to demonstrate the detection of the SLN using intraoperative fluorescence imaging in patients with cervical and vulvar cancer. Fluorescence imaging is used in conjunction with the standard procedure, consisting of radiocolloid and a blue dye. In the future, intraoperative fluorescence imaging might replace the current method and is also easily transferable to other indications like breast cancer and melanoma.
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DOI: 10.3791/2225
PubMed: 21048667
PubMed Central: 3185642
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Lucia M. A. Crane<affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID3">Department of Obstetrics and Gynaecology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation>Le document en format XML
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Tim" last="Buddingh">K. Tim Buddingh</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Harlaar, Niels J" sort="Harlaar, Niels J" uniqKey="Harlaar N" first="Niels J." last="Harlaar">Niels J. Harlaar</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Pleijhuis, Rick G" sort="Pleijhuis, Rick G" uniqKey="Pleijhuis R" first="Rick G." last="Pleijhuis">Rick G. Pleijhuis</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Sarantopoulos, Athanasios" sort="Sarantopoulos, Athanasios" uniqKey="Sarantopoulos A" first="Athanasios" last="Sarantopoulos">Athanasios Sarantopoulos</name><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation></author><author><name sortKey="Van Der Zee, Ate G J" sort="Van Der Zee, Ate G J" uniqKey="Van Der Zee A" first="Ate G. J." last="Van Der Zee">Ate G. J. Van Der Zee</name><affiliation><nlm:aff id="ID3">Department of Obstetrics and Gynaecology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Ntziachristos, Vasilis" sort="Ntziachristos, Vasilis" uniqKey="Ntziachristos V" first="Vasilis" last="Ntziachristos">Vasilis Ntziachristos</name><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation></author><author><name sortKey="Van Dam, Gooitzen M" sort="Van Dam, Gooitzen M" uniqKey="Van Dam G" first="Gooitzen M." last="Van Dam">Gooitzen M. Van Dam</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21048667</idno><idno type="pmc">3185642</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3185642</idno><idno type="RBID">PMC:3185642</idno><idno type="doi">10.3791/2225</idno><date when="2010">2010</date><idno type="wicri:Area/Pmc/Corpus">000375</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000375</idno><idno type="wicri:Area/Pmc/Curation">000375</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000375</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology</title><author><name sortKey="Crane, Lucia M A" sort="Crane, Lucia M A" uniqKey="Crane L" first="Lucia M. A." last="Crane">Lucia M. A. Crane</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Themelis, George" sort="Themelis, George" uniqKey="Themelis G" first="George" last="Themelis">George Themelis</name><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation></author><author><name sortKey="Buddingh, K Tim" sort="Buddingh, K Tim" uniqKey="Buddingh K" first="K. Tim" last="Buddingh">K. Tim Buddingh</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Harlaar, Niels J" sort="Harlaar, Niels J" uniqKey="Harlaar N" first="Niels J." last="Harlaar">Niels J. Harlaar</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Pleijhuis, Rick G" sort="Pleijhuis, Rick G" uniqKey="Pleijhuis R" first="Rick G." last="Pleijhuis">Rick G. Pleijhuis</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Sarantopoulos, Athanasios" sort="Sarantopoulos, Athanasios" uniqKey="Sarantopoulos A" first="Athanasios" last="Sarantopoulos">Athanasios Sarantopoulos</name><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation></author><author><name sortKey="Van Der Zee, Ate G J" sort="Van Der Zee, Ate G J" uniqKey="Van Der Zee A" first="Ate G. J." last="Van Der Zee">Ate G. J. Van Der Zee</name><affiliation><nlm:aff id="ID3">Department of Obstetrics and Gynaecology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author><author><name sortKey="Ntziachristos, Vasilis" sort="Ntziachristos, Vasilis" uniqKey="Ntziachristos V" first="Vasilis" last="Ntziachristos">Vasilis Ntziachristos</name><affiliation><nlm:aff id="ID2">Helmholtz Zentrum, Technical University Munich</nlm:aff><wicri:noCountry code="subfield">Technical University Munich</wicri:noCountry></affiliation></author><author><name sortKey="Van Dam, Gooitzen M" sort="Van Dam, Gooitzen M" uniqKey="Van Dam G" first="Gooitzen M." last="Van Dam">Gooitzen M. Van Dam</name><affiliation><nlm:aff id="ID1">Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</nlm:aff><wicri:noCountry code="subfield">University Medical Center Groningen</wicri:noCountry></affiliation></author></analytic><series><title level="j">Journal of Visualized Experiments : JoVE</title><idno type="eISSN">1940-087X</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The prognosis in virtually all solid tumors depends on the presence or absence of lymph node metastases.<sup>1-3</sup> Surgical treatment most often combines radical excision of the tumor with a full lymphadenectomy in the drainage area of the tumor. However, removal of lymph nodes is associated with increased morbidity due to infection, wound breakdown and lymphedema.<sup>4,5</sup> As an alternative, the sentinel lymph node procedure (SLN) was developed several decades ago to detect the first draining lymph node from the tumor.<sup>6</sup> In case of lymphogenic dissemination, the SLN is the first lymph node that is affected (Figure 1). Hence, if the SLN does not contain metastases, downstream lymph nodes will also be free from tumor metastases and need not to be removed. The SLN procedure is part of the treatment for many tumor types, like breast cancer and melanoma, but also for cancer of the vulva and cervix.<sup>7</sup> The current standard methodology for SLN-detection is by peritumoral injection of radiocolloid one day prior to surgery, and a colored dye intraoperatively. Disadvantages of the procedure in cervical and vulvar cancer are multiple injections in the genital area, leading to increased psychological distress for the patient, and the use of radioactive colloid.</p><p>Multispectral fluorescence imaging is an emerging imaging modality that can be applied intraoperatively without the need for injection of radiocolloid. For intraoperative fluorescence imaging, two components are needed: a fluorescent agent and a quantitative optical system for intraoperative imaging. As a fluorophore we have used indocyanine green (ICG). ICG has been used for many decades to assess cardiac function, cerebral perfusion and liver perfusion.<sup>8</sup> It is an inert drug with a safe pharmaco-biological profile. When excited at around 750 nm, it emits light in the near-infrared spectrum around 800 nm. A custom-made multispectral fluorescence imaging camera system was used.<sup>9</sup>.</p><p>The aim of this video article is to demonstrate the detection of the SLN using intraoperative fluorescence imaging in patients with cervical and vulvar cancer. Fluorescence imaging is used in conjunction with the standard procedure, consisting of radiocolloid and a blue dye. In the future, intraoperative fluorescence imaging might replace the current method and is also easily transferable to other indications like breast cancer and melanoma.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Tinga, Dj" uniqKey="Tinga D">DJ Tinga</name></author><author><name sortKey="Bouma, J" uniqKey="Bouma J">J Bouma</name></author><author><name sortKey="Aalders, Jg" uniqKey="Aalders J">JG Aalders</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcmahon, Cj" uniqKey="Mcmahon C">CJ McMahon</name></author><author><name sortKey="Rofsky, Nm" uniqKey="Rofsky N">NM Rofsky</name></author><author><name sortKey="Pedrosa, I" uniqKey="Pedrosa I">I Pedrosa</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Zivanovic, O" uniqKey="Zivanovic O">O Zivanovic</name></author><author><name sortKey="Khoury Collado, F" uniqKey="Khoury Collado F">F Khoury-Collado</name></author><author><name sortKey="Abu Rustum, Nr" uniqKey="Abu Rustum N">NR Abu-Rustum</name></author><author><name sortKey="Gemignani, Ml" uniqKey="Gemignani M">ML Gemignani</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fuller, J" uniqKey="Fuller J">J Fuller</name></author><author><name sortKey="Guderian, D" uniqKey="Guderian D">D Guderian</name></author><author><name sortKey="Kohler, C" uniqKey="Kohler C">C Kohler</name></author><author><name sortKey="Schneider, A" uniqKey="Schneider A">A Schneider</name></author><author><name sortKey="Wendt, Tg" uniqKey="Wendt T">TG Wendt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ayhan, A" uniqKey="Ayhan A">A Ayhan</name></author><author><name sortKey="Celik, H" uniqKey="Celik H">H Celik</name></author><author><name sortKey="Dursun, P" uniqKey="Dursun P">P Dursun</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tanis, Pj" uniqKey="Tanis P">PJ Tanis</name></author><author><name sortKey="Nieweg, Oe" uniqKey="Nieweg O">OE Nieweg</name></author><author><name sortKey="Valdes Olmos, Ra" uniqKey="Valdes Olmos R">RA Valdes Olmos</name></author><author><name sortKey="Rutgers, Ej" uniqKey="Rutgers E">EJ Rutgers</name></author><author><name sortKey="Kroon, Bb" uniqKey="Kroon B">BB Kroon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ghobashy, Aeel" uniqKey="Ghobashy A">AEEl Ghobashy</name></author><author><name sortKey="Saidi, Sa" uniqKey="Saidi S">SA Saidi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Alford, R" uniqKey="Alford R">R Alford</name></author><author><name sortKey="Simpson, Hm" uniqKey="Simpson H">HM Simpson</name></author><author><name sortKey="Duberman, J" uniqKey="Duberman J">J Duberman</name></author><author><name sortKey="Hill, Gc" uniqKey="Hill G">GC Hill</name></author><author><name sortKey="Ogawa, M" uniqKey="Ogawa M">M Ogawa</name></author><author><name sortKey="Regino, C" uniqKey="Regino C">C Regino</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Themelis, G" uniqKey="Themelis G">G Themelis</name></author><author><name sortKey="Yoo, Js" uniqKey="Yoo J">JS Yoo</name></author><author><name sortKey="Soh, Ks" uniqKey="Soh K">KS Soh</name></author><author><name sortKey="Schulz, R" uniqKey="Schulz R">R Schulz</name></author><author><name sortKey="Ntziachristos, V" uniqKey="Ntziachristos V">V Ntziachristos</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Vis Exp</journal-id><journal-id journal-id-type="iso-abbrev">J Vis Exp</journal-id><journal-id journal-id-type="publisher-id">JoVE</journal-id><journal-title-group><journal-title>Journal of Visualized Experiments : JoVE</journal-title></journal-title-group><issn pub-type="epub">1940-087X</issn><publisher><publisher-name>MyJove Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21048667</article-id><article-id pub-id-type="pmc">3185642</article-id><article-id pub-id-type="publisher-id">2225</article-id><article-id pub-id-type="doi">10.3791/2225</article-id><article-categories><subj-group subj-group-type="heading"><subject>Medicine</subject></subj-group></article-categories><title-group><article-title>Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Crane</surname><given-names>Lucia M.A.</given-names></name><xref ref-type="aff" rid="ID1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Themelis</surname><given-names>George</given-names></name><xref ref-type="aff" rid="ID2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Buddingh</surname><given-names>K. Tim</given-names></name><xref ref-type="aff" rid="ID1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Harlaar</surname><given-names>Niels J.</given-names></name><xref ref-type="aff" rid="ID1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Pleijhuis</surname><given-names>Rick G.</given-names></name><xref ref-type="aff" rid="ID1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sarantopoulos</surname><given-names>Athanasios</given-names></name><xref ref-type="aff" rid="ID2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>van der Zee</surname><given-names>Ate G.J.</given-names></name><xref ref-type="aff" rid="ID3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ntziachristos</surname><given-names>Vasilis</given-names></name><xref ref-type="aff" rid="ID2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>van Dam</surname><given-names>Gooitzen M.</given-names></name><xref ref-type="aff" rid="ID1"><sup>1</sup></xref></contrib></contrib-group><aff id="ID1"><sup>1</sup>Department of Surgery, Division of Surgical Oncology, University Medical Center Groningen</aff><aff id="ID2"><sup>2</sup>Helmholtz Zentrum, Technical University Munich</aff><aff id="ID3"><sup>3</sup>Department of Obstetrics and Gynaecology, University Medical Center Groningen</aff><author-notes><fn><p>Correspondence to: Gooitzen M. van Dam at <email>g.m.van.dam@chir.umcg.nl</email></p></fn></author-notes><pub-date pub-type="collection"><year>2010</year></pub-date><pub-date pub-type="epub"><day>20</day><month>10</month><year>2010</year></pub-date><pub-date pub-type="pmc-release"><day>20</day><month>10</month><year>2010</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on the
<issue>44</issue><elocation-id>2225</elocation-id><permissions><copyright-statement>Copyright © 2010, Journal of Visualized Experiments</copyright-statement><copyright-year>2010</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. To view a copy of this license, visit<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-nd/3.0/">http://creativecommons.org/licenses/by-nc-nd/3.0/</ext-link></license-p></license></permissions><abstract><p>The prognosis in virtually all solid tumors depends on the presence or absence of lymph node metastases.<sup>1-3</sup> Surgical treatment most often combines radical excision of the tumor with a full lymphadenectomy in the drainage area of the tumor. However, removal of lymph nodes is associated with increased morbidity due to infection, wound breakdown and lymphedema.<sup>4,5</sup> As an alternative, the sentinel lymph node procedure (SLN) was developed several decades ago to detect the first draining lymph node from the tumor.<sup>6</sup> In case of lymphogenic dissemination, the SLN is the first lymph node that is affected (Figure 1). Hence, if the SLN does not contain metastases, downstream lymph nodes will also be free from tumor metastases and need not to be removed. The SLN procedure is part of the treatment for many tumor types, like breast cancer and melanoma, but also for cancer of the vulva and cervix.<sup>7</sup> The current standard methodology for SLN-detection is by peritumoral injection of radiocolloid one day prior to surgery, and a colored dye intraoperatively. Disadvantages of the procedure in cervical and vulvar cancer are multiple injections in the genital area, leading to increased psychological distress for the patient, and the use of radioactive colloid.</p><p>Multispectral fluorescence imaging is an emerging imaging modality that can be applied intraoperatively without the need for injection of radiocolloid. For intraoperative fluorescence imaging, two components are needed: a fluorescent agent and a quantitative optical system for intraoperative imaging. As a fluorophore we have used indocyanine green (ICG). ICG has been used for many decades to assess cardiac function, cerebral perfusion and liver perfusion.<sup>8</sup> It is an inert drug with a safe pharmaco-biological profile. When excited at around 750 nm, it emits light in the near-infrared spectrum around 800 nm. A custom-made multispectral fluorescence imaging camera system was used.<sup>9</sup>.</p><p>The aim of this video article is to demonstrate the detection of the SLN using intraoperative fluorescence imaging in patients with cervical and vulvar cancer. Fluorescence imaging is used in conjunction with the standard procedure, consisting of radiocolloid and a blue dye. In the future, intraoperative fluorescence imaging might replace the current method and is also easily transferable to other indications like breast cancer and melanoma.</p></abstract><kwd-group kwd-group-type="author-generated"><kwd>Medicine</kwd><kwd>Issue 44</kwd><kwd>Image-guided surgery</kwd><kwd>multispectral fluorescence</kwd><kwd>sentinel lymph node</kwd><kwd>gynecologic oncology</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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