WE-C-217BCD-01: Development of an Integrated Multimodal Imaging System (IMIS) for Surgical Guidance

Area of Science:

• Medical Imaging
• Surgical Technology
• Biomedical Optics

Background:

• Intraoperative imaging is crucial for surgical guidance.
• Multimodal imaging offers enhanced visualization capabilities.
• Current systems may lack real-time, integrated capabilities.

Purpose of the Study:

• To develop an intraoperative multimodal imaging system (IMIS).
• To integrate gamma ray scintigraphy with visible and near-infrared fluorescence (NIRf) imaging.
• To provide simultaneous real-time surgical guidance.

Main Methods:

• Developed an IMIS combining a gamma camera and a visible/NIRf system.
• Evaluated optical components using bench-top tests and phantoms.
• Assessed spatial resolution, depth-dependent visualization, and excitation radiation rejection.
• Tested the gamma camera in a pilot study for SLN biopsy in melanoma patients.
• Imaged a mouse breast cancer model using the visible/NIRf system.

Main Results:

• The SiPM gamma camera achieved 100% detection of positive lymph nodes intraoperatively.
• Visible light camera system demonstrated a contrast transfer function >10% up to 3.2 lp/mm.
• NIRf system achieved a signal-to-noise ratio (SNR) > 2 for lesions up to 8 mm deep with 20 μM ICG.
• Excitation filters provided nearly complete rejection of backscattered light (<1% leakage).

Conclusions:

• The optical component of the IMIS exhibits high spatial resolution and excellent background rejection.
• The system provides good target SNR for realistic tracer concentrations and depths.
• The IMIS is capable of accurate, coregistered, video-rate visible/NIRf imaging for surgical guidance.