Fluorescence Guided Surgery

Fluorescence Guided Surgery for Pediatric Oncology

Background

Tumor resection is one of the important pillars in the treatment of pediatric patients with solid tumors. Tumor resections remain often technically challenging due to the difficulty to distinguish visually and/or tactilely, between tumor and healthy surrounding tissue, and also because the tumor can encase blood vessels and nerves. Presence of positive resection margins which indicate residual tumor after resection, is a strong predictor of tumor recurrence and a worse prognosis.

In order to resect all tumor present, achieve negative resection margins and preserve healthy tissue, it is of great importance to accurately discriminate tumor from healthy tissue. Novel intra-operative imaging modalities have been developed to assist surgeons with the visual identification of tumor tissue. One of the most promising modalities is fluorescence-guided surgery (FGS), which makes use of near-infrared (NIR) fluorescence imaging. By injecting a fluorescent agent, tumor tissue can be visualized in real-time using a specific NIR-camera system.


Fluorescence Guided Surgery has several advantages when compared to other intra-operative detection methods. To start with, the maximum absorption (765nm) and peak fluorescence emission (830nm) wavelengths are in the NIR spectrum, which results in a depth penetration up to 10mm and reduced background fluorescence. This enables detection of tumor tissue even if it is covered by blood or a thin layer of tissue. In addition, fluorescent dyes make use of non-ionizing radiation (unlike intraoperative computed tomography or radio-active agents). Moreover, they are invisible to the naked eye and thus does not contaminate the surgical field nor results in long lasting tattoos. Finally, it is easy to use and does not interrupt the surgical workflow. 


Aim

Perform pre-clinical and clinical studies in the field of Fluorescence Guided Surgery with the ultimate goal to improve care by implementing this promising technique in the Princess Máxima Center.


Project Outcomes


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