Real-time sentinel lymph node biopsy guidance using combined ultrasound, photoacoustic, fluorescence imaging: in vivo proof-of-principle and validation with nodal obstruction
Identifieur interne : 000981 ( Pmc/Curation ); précédent : 000980; suivant : 000982Real-time sentinel lymph node biopsy guidance using combined ultrasound, photoacoustic, fluorescence imaging: in vivo proof-of-principle and validation with nodal obstruction
Auteurs : Jeeun Kang [Corée du Sud] ; Jin Ho Chang [Corée du Sud] ; Sun Mi Kim [Corée du Sud] ; Hak Jong Lee [Corée du Sud] ; Haemin Kim [Corée du Sud] ; Brian C. Wilson [Canada] ; Tai-Kyong Song [Corée du Sud]Source :
- Scientific Reports [ 2045-2322 ] ; 2017.
Abstract
Precise sentinel lymph node (SLN) identification is crucial not only for accurate diagnosis of micro-metastases at an early stage of cancer progression but also for reducing the number of SLN biopsies (SLNB) to minimize their severe side effects. Furthermore, it is desirable that an SLNB guidance should be as safe as possible in routine clinical use. Although there are currently various SLNB guidance methods for pre-operative or intra-operative assessment, none are ideal. We propose a real-time SLNB guidance method using contrast-enhanced tri-modal images (i.e., ultrasound, photoacoustic, and fluorescence) acquired by a recently developed hand-held tri-modal probe. The major advantage of tri-modal imaging is demonstrated here through an
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DOI: 10.1038/srep45008
PubMed: 28327582
PubMed Central: 5361205
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Real-time sentinel lymph node biopsy guidance using combined ultrasound, photoacoustic, fluorescence imaging: <italic>in vivo</italic> proof-of-principle and validation with nodal obstruction</title><author><name sortKey="Kang, Jeeun" sort="Kang, Jeeun" uniqKey="Kang J" first="Jeeun" last="Kang">Jeeun Kang</name><affiliation wicri:level="1"><nlm:aff id="a1"><institution>Department of Electronic Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chang, Jin Ho" sort="Chang, Jin Ho" uniqKey="Chang J" first="Jin Ho" last="Chang">Jin Ho Chang</name><affiliation wicri:level="1"><nlm:aff id="a1"><institution>Department of Electronic Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="a2"><institution>Sogang Institute of Advanced Technology, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="a3"><institution>Department of Biomedical Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Sun Mi" sort="Kim, Sun Mi" uniqKey="Kim S" first="Sun Mi" last="Kim">Sun Mi Kim</name><affiliation wicri:level="1"><nlm:aff id="a4"><institution>Department of Radiology, Seoul National University of Bundang Hospital</institution>, Kyeonggi-do, 13620,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Hak Jong" sort="Lee, Hak Jong" uniqKey="Lee H" first="Hak Jong" last="Lee">Hak Jong Lee</name><affiliation wicri:level="1"><nlm:aff id="a4"><institution>Department of Radiology, Seoul National University of Bundang Hospital</institution>, Kyeonggi-do, 13620,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Haemin" sort="Kim, Haemin" uniqKey="Kim H" first="Haemin" last="Kim">Haemin Kim</name><affiliation wicri:level="1"><nlm:aff id="a3"><institution>Department of Biomedical Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wilson, Brian C" sort="Wilson, Brian C" uniqKey="Wilson B" first="Brian C." last="Wilson">Brian C. Wilson</name><affiliation wicri:level="1"><nlm:aff id="a5"><institution>Princess Margaret Cancer Centre, University Health Network</institution>, M5G 1L7,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="a6"><institution>Department of Medical Biophysics, Faculty of Medicine, University of Toronto</institution>, Ontario M5G 1L7,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Song, Tai Kyong" sort="Song, Tai Kyong" uniqKey="Song T" first="Tai-Kyong" last="Song">Tai-Kyong Song</name><affiliation wicri:level="1"><nlm:aff id="a1"><institution>Department of Electronic Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28327582</idno><idno type="pmc">5361205</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361205</idno><idno type="RBID">PMC:5361205</idno><idno type="doi">10.1038/srep45008</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000981</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000981</idno><idno type="wicri:Area/Pmc/Curation">000981</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000981</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Real-time sentinel lymph node biopsy guidance using combined ultrasound, photoacoustic, fluorescence imaging: <italic>in vivo</italic> proof-of-principle and validation with nodal obstruction</title><author><name sortKey="Kang, Jeeun" sort="Kang, Jeeun" uniqKey="Kang J" first="Jeeun" last="Kang">Jeeun Kang</name><affiliation wicri:level="1"><nlm:aff id="a1"><institution>Department of Electronic Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chang, Jin Ho" sort="Chang, Jin Ho" uniqKey="Chang J" first="Jin Ho" last="Chang">Jin Ho Chang</name><affiliation wicri:level="1"><nlm:aff id="a1"><institution>Department of Electronic Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="a2"><institution>Sogang Institute of Advanced Technology, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="a3"><institution>Department of Biomedical Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Sun Mi" sort="Kim, Sun Mi" uniqKey="Kim S" first="Sun Mi" last="Kim">Sun Mi Kim</name><affiliation wicri:level="1"><nlm:aff id="a4"><institution>Department of Radiology, Seoul National University of Bundang Hospital</institution>, Kyeonggi-do, 13620,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lee, Hak Jong" sort="Lee, Hak Jong" uniqKey="Lee H" first="Hak Jong" last="Lee">Hak Jong Lee</name><affiliation wicri:level="1"><nlm:aff id="a4"><institution>Department of Radiology, Seoul National University of Bundang Hospital</institution>, Kyeonggi-do, 13620,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kim, Haemin" sort="Kim, Haemin" uniqKey="Kim H" first="Haemin" last="Kim">Haemin Kim</name><affiliation wicri:level="1"><nlm:aff id="a3"><institution>Department of Biomedical Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wilson, Brian C" sort="Wilson, Brian C" uniqKey="Wilson B" first="Brian C." last="Wilson">Brian C. Wilson</name><affiliation wicri:level="1"><nlm:aff id="a5"><institution>Princess Margaret Cancer Centre, University Health Network</institution>, M5G 1L7,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="a6"><institution>Department of Medical Biophysics, Faculty of Medicine, University of Toronto</institution>, Ontario M5G 1L7,<country>Canada</country></nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Song, Tai Kyong" sort="Song, Tai Kyong" uniqKey="Song T" first="Tai-Kyong" last="Song">Tai-Kyong Song</name><affiliation wicri:level="1"><nlm:aff id="a1"><institution>Department of Electronic Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Scientific Reports</title><idno type="eISSN">2045-2322</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Precise sentinel lymph node (SLN) identification is crucial not only for accurate diagnosis of micro-metastases at an early stage of cancer progression but also for reducing the number of SLN biopsies (SLNB) to minimize their severe side effects. Furthermore, it is desirable that an SLNB guidance should be as safe as possible in routine clinical use. Although there are currently various SLNB guidance methods for pre-operative or intra-operative assessment, none are ideal. We propose a real-time SLNB guidance method using contrast-enhanced tri-modal images (i.e., ultrasound, photoacoustic, and fluorescence) acquired by a recently developed hand-held tri-modal probe. The major advantage of tri-modal imaging is demonstrated here through an <italic>in vivo</italic> study of the technically-difficult case of nodal obstruction that frequently leads to false-negative results in patients. The results in a tumor model in rabbits and normal controls showed that tri-modal imaging is capable of clearly identifying obstructed SLNs and of indicating their metastatic involvement. Based on these findings, we propose an SLNB protocol to help surgeons take full advantage of the complementary information obtained from tri-modal imaging, including for pre-operative localization, intra-operative biopsy guidance and post-operative analysis.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Lyman, G H" uniqKey="Lyman G">G. H. Lyman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lyman, G H" uniqKey="Lyman G">G. H. Lyman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, S L" uniqKey="Chen S">S. L. Chen</name></author><author><name sortKey="Iddings, D M" uniqKey="Iddings D">D. M. Iddings</name></author><author><name sortKey="Scheri, R P" uniqKey="Scheri R">R. P. Scheri</name></author><author><name sortKey="Bilchik, A J" uniqKey="Bilchik A">A. J. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Sci Rep</journal-id><journal-id journal-id-type="iso-abbrev">Sci Rep</journal-id><journal-title-group><journal-title>Scientific Reports</journal-title></journal-title-group><issn pub-type="epub">2045-2322</issn><publisher><publisher-name>Nature Publishing Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28327582</article-id><article-id pub-id-type="pmc">5361205</article-id><article-id pub-id-type="pii">srep45008</article-id><article-id pub-id-type="doi">10.1038/srep45008</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Real-time sentinel lymph node biopsy guidance using combined ultrasound, photoacoustic, fluorescence imaging: <italic>in vivo</italic> proof-of-principle and validation with nodal obstruction</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kang</surname><given-names>Jeeun</given-names></name><xref ref-type="aff" rid="a1">1</xref></contrib><contrib contrib-type="author"><name><surname>Chang</surname><given-names>Jin Ho</given-names></name><xref ref-type="corresp" rid="c1">a</xref><xref ref-type="aff" rid="a1">1</xref><xref ref-type="aff" rid="a2">2</xref><xref ref-type="aff" rid="a3">3</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Sun Mi</given-names></name><xref ref-type="aff" rid="a4">4</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Hak Jong</given-names></name><xref ref-type="aff" rid="a4">4</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Haemin</given-names></name><xref ref-type="aff" rid="a3">3</xref></contrib><contrib contrib-type="author"><name><surname>Wilson</surname><given-names>Brian C.</given-names></name><xref ref-type="aff" rid="a5">5</xref><xref ref-type="aff" rid="a6">6</xref></contrib><contrib contrib-type="author"><name><surname>Song</surname><given-names>Tai-Kyong</given-names></name><xref ref-type="corresp" rid="c2">b</xref><xref ref-type="aff" rid="a1">1</xref></contrib><aff id="a1"><label>1</label><institution>Department of Electronic Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></aff><aff id="a2"><label>2</label><institution>Sogang Institute of Advanced Technology, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></aff><aff id="a3"><label>3</label><institution>Department of Biomedical Engineering, Sogang University</institution>, Seoul, 04107,<country>South Korea</country></aff><aff id="a4"><label>4</label><institution>Department of Radiology, Seoul National University of Bundang Hospital</institution>, Kyeonggi-do, 13620,<country>South Korea</country></aff><aff id="a5"><label>5</label><institution>Princess Margaret Cancer Centre, University Health Network</institution>, M5G 1L7,<country>Canada</country></aff><aff id="a6"><label>6</label><institution>Department of Medical Biophysics, Faculty of Medicine, University of Toronto</institution>, Ontario M5G 1L7,<country>Canada</country></aff></contrib-group><author-notes><corresp id="c1"><label>a</label><email>jhchang@sogang.ac.kr</email></corresp><corresp id="c2"><label>b</label><email>tksong@sogang.ac.kr</email></corresp></author-notes><pub-date pub-type="epub"><day>22</day><month>03</month><year>2017</year></pub-date><pub-date pub-type="collection"><year>2017</year></pub-date><volume>7</volume><elocation-id>45008</elocation-id><history><date date-type="received"><day>29</day><month>09</month><year>2016</year></date><date date-type="accepted"><day>20</day><month>02</month><year>2017</year></date></history><permissions><copyright-statement>Copyright © 2017, The Author(s)</copyright-statement><copyright-year>2017</copyright-year><copyright-holder>The Author(s)</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by/4.0/"><pmc-comment>author-paid</pmc-comment>
<license-p>This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link></license-p></license></permissions><abstract><p>Precise sentinel lymph node (SLN) identification is crucial not only for accurate diagnosis of micro-metastases at an early stage of cancer progression but also for reducing the number of SLN biopsies (SLNB) to minimize their severe side effects. Furthermore, it is desirable that an SLNB guidance should be as safe as possible in routine clinical use. Although there are currently various SLNB guidance methods for pre-operative or intra-operative assessment, none are ideal. We propose a real-time SLNB guidance method using contrast-enhanced tri-modal images (i.e., ultrasound, photoacoustic, and fluorescence) acquired by a recently developed hand-held tri-modal probe. The major advantage of tri-modal imaging is demonstrated here through an <italic>in vivo</italic> study of the technically-difficult case of nodal obstruction that frequently leads to false-negative results in patients. The results in a tumor model in rabbits and normal controls showed that tri-modal imaging is capable of clearly identifying obstructed SLNs and of indicating their metastatic involvement. Based on these findings, we propose an SLNB protocol to help surgeons take full advantage of the complementary information obtained from tri-modal imaging, including for pre-operative localization, intra-operative biopsy guidance and post-operative analysis.</p></abstract></article-meta></front><floats-group><fig id="f1"><label>Figure 1</label><caption><title>Schematic diagram of the tri-modal imaging system and probe.</title><p>WL: white light, SHG: second-harmonic generator, OPO: optical parametric oscillator, DAQ: data acquisition board.</p></caption><graphic xlink:href="srep45008-f1"></graphic></fig><fig id="f2"><label>Figure 2</label><caption><p>(<bold>a</bold>) US and (<bold>b</bold>) PA cross-sectional <italic>in vivo</italic> images of control (left) and tumor-bearing (right) rabbits acquired in the pre-operative localization session. SLNs are indicated by the white arrows in the US images. The PA images, taken at 90 s after dye injection, covered the region of interest indicated by the dotted rectangle in the US images (see <xref ref-type="supplementary-material" rid="S1">Fig. S1</xref> for the PA images acquired at 0, 30, 60 and 90 s.). The white scale bar in the US image indicates 1 cm. (<bold>c</bold>) PA intensity as a function of time following contrast injection, averaged over the region of interest indicated by white dotted circles in the PA images. BG denotes resting-state background.</p></caption><graphic xlink:href="srep45008-f2"></graphic></fig><fig id="f3"><label>Figure 3</label><caption><p>FL images obtained during the intra-operative guidance session: (<bold>a</bold>) control and (<bold>b</bold>) tumor-bearing; PT-primary tumor, LC-lymphatic channel.</p></caption><graphic xlink:href="srep45008-f3"></graphic></fig><fig id="f4"><label>Figure 4</label><caption><p>Post-operative analysis: <italic>ex vivo</italic> FL validation of the resected SLNs from (<bold>a</bold>) control and (<bold>b</bold>) tumor-bearing rabbits. The blue arrow in (<bold>b</bold>) indicates the direction of FL imaging available during <italic>in vivo</italic> surgical guidance. The black rectangles indicate the regions-of-interest for FL intensity measurements. H&E stained sections are shown for the corresponding (<bold>c</bold>) control and (<bold>d</bold>) tumor-bearing SLN: MT-metastatic tumor, EL-efferent lymph vessel, ALV-afferent lymph vessel, NLN-normal lymph node tissue.</p></caption><graphic xlink:href="srep45008-f4"></graphic></fig><fig id="f5"><label>Figure 5</label><caption><title>Flowchart of proposed SLNB guidance using contrast-enhanced tri-modal imaging.</title></caption><graphic xlink:href="srep45008-f5"></graphic></fig><table-wrap position="float" id="t1"><label>Table 1</label><caption><title>Conventional pre- and intra-operative SLNB guidance methods.</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col></colgroup><thead valign="bottom"><tr><th rowspan="2" align="left" valign="top" charoff="50">Aims</th><th colspan="6" align="center" valign="top" charoff="50">Pre-operative</th><th colspan="3" align="center" valign="top" charoff="50">Intra-operative</th></tr><tr><th colspan="6" align="center" valign="top" charoff="50">Precise SLN localization overview around the suspicious nodal region (axillary or inguinal regions) detection of multiple-basin drainage</th><th colspan="3" align="center" valign="top" charoff="50">Precise SLN localization with wide field-of-view in real-time</th></tr></thead><tbody valign="top"><tr><td align="left" valign="top" charoff="50">Modality</td><td align="center" valign="top" charoff="50">LS</td><td align="center" valign="top" charoff="50">CT</td><td align="center" valign="top" charoff="50">PET</td><td align="center" valign="top" charoff="50">MRI</td><td align="center" valign="top" charoff="50">US</td><td align="center" valign="top" charoff="50">PA</td><td align="center" valign="top" charoff="50">BD</td><td align="center" valign="top" charoff="50">RD</td><td align="center" valign="top" charoff="50">FLD</td></tr><tr><td align="left" valign="top" charoff="50">Spatial resolution</td><td align="center" valign="top" charoff="50">20 mm</td><td align="center" valign="top" charoff="50">50 μm</td><td align="center" valign="top" charoff="50">1–2 mm</td><td align="center" valign="top" charoff="50">50 μm</td><td align="center" valign="top" charoff="50">400 μm</td><td align="center" valign="top" charoff="50">800 μm</td><td align="center" valign="top" charoff="50">Unaided visual resolution</td><td align="center" valign="top" charoff="50">>10 mm</td><td align="center" valign="top" charoff="50">100 μm</td></tr><tr><td align="left" valign="top" charoff="50">Throughput</td><td colspan="4" align="center" valign="top" charoff="50">Low</td><td colspan="5" align="center" valign="top" charoff="50">High</td></tr><tr><td align="left" valign="top" charoff="50">Image format</td><td align="center" valign="top" charoff="50">Projection in single direction</td><td colspan="3" align="center" valign="top" charoff="50">Tomography</td><td colspan="2" align="center" valign="top" charoff="50">Cross-section and/or coronal planes</td><td align="center" valign="top" charoff="50"><italic>En face</italic> to the tissue surface</td><td align="center" valign="top" charoff="50">Freehand point scanning</td><td align="center" valign="top" charoff="50"><italic>En face</italic> to the tissue surface</td></tr><tr><td align="left" valign="top" charoff="50">Sensing depth</td><td colspan="4" align="center" valign="top" charoff="50">>30 cm</td><td align="center" valign="top" charoff="50">>20 cm</td><td align="center" valign="top" charoff="50">~7 cm</td><td align="center" valign="top" charoff="50">~1 mm</td><td align="center" valign="top" charoff="50">>50 mm</td><td align="center" valign="top" charoff="50">~1–2 mm</td></tr><tr><td align="left" valign="top" charoff="50">Exogenous contrast agent</td><td align="center" valign="top" charoff="50">Radio-active tracer</td><td align="center" valign="top" charoff="50">Iodinated contrast agent</td><td align="center" valign="top" charoff="50">Positron-emitting radionuclide tracer</td><td align="center" valign="top" charoff="50">Magnetic contrast agent (e.g., paramagnetic iron oxide, gadolinium chelates)</td><td align="center" valign="top" charoff="50">Micro-bubbles</td><td align="center" valign="top" charoff="50">Molecular dyes or NPs with high optical absorption</td><td align="center" valign="top" charoff="50">Methylene blue</td><td align="center" valign="top" charoff="50">Radio-active tracer</td><td align="center" valign="top" charoff="50">Molecular dyes, activatable beacons, NPs</td></tr><tr><td align="left" valign="top" charoff="50">Cost</td><td align="center" valign="top" charoff="50">High</td><td align="center" valign="top" charoff="50">High</td><td align="center" valign="top" charoff="50">High</td><td align="center" valign="top" charoff="50">High</td><td align="center" valign="top" charoff="50">Low</td><td align="center" valign="top" charoff="50">not established</td><td align="center" valign="top" charoff="50">Low</td><td align="center" valign="top" charoff="50">High</td><td align="center" valign="top" charoff="50">Medium</td></tr><tr><td align="left" valign="top" charoff="50">Ionization radiation?</td><td align="center" valign="top" charoff="50">yes</td><td align="center" valign="top" charoff="50">yes</td><td align="center" valign="top" charoff="50">yes</td><td align="center" valign="top" charoff="50">no</td><td align="center" valign="top" charoff="50">no</td><td align="center" valign="top" charoff="50">no</td><td align="center" valign="top" charoff="50">no</td><td align="center" valign="top" charoff="50">no</td><td align="center" valign="top" charoff="50">no</td></tr></tbody></table></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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