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The thoracic section of the aorta begins at the T5 vertebra and extends to the T12 level at the diaphragm, initially progressing through the mediastinum to the left of the spinal column. Throughout its course in the thoracic segment, the thoracic aorta emits various offshoots known collectively as visceral and parietal branches. The branches that predominantly supply blood to visceral organs are termed visceral branches and include bronchial, pericardial, esophageal, and mediastinal arteries,...
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The thoracic or rib cage forms the body's thorax (chest) portion. Its primary function in the body is to protect vital organs in the thoracic cavity, such as the heart and the lungs. It consists of 12 pairs of ribs with their costal cartilages and the sternum. The ribs are anchored posteriorly to the 12 thoracic vertebrae (T1-T12).
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Ribs are curved, flattened bones forming the thoracic cavity wall with the thoracic muscles. There are 12 pairs of thoracic ribs. The posterior ends of all the ribs articulate with the T1–T12 thoracic vertebrae. In contrast,the anterior ends of most ribs attach to the sternum via their costal cartilages.
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Breathing, otherwise known as pulmonary ventilation, is the process of air movement into and out of the lungs. The main mechanisms propelling pulmonary ventilation are atmospheric pressure (Patm), intra-pulmonary (Ppul ) or intra-alveolar pressure (Palv) within the alveoli, and intrapleural pressure (Pip) within the pleural cavity.
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Photoluminescence is a process where a molecule absorbs light energy and re-emits it in the form of light. This phenomenon occurs when a substance absorbs photons, promoting its electrons to higher energy level excited states, followed by a relaxation process in which the electrons return to their original ground state energy levels and emit light. Photoluminescence is widely observed in various materials, including semiconductors, and organic and inorganic compounds.
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Atomic fluorescence spectroscopy (AFS) is an analytical technique that involves the electronic transitions of atoms in a flame, furnace, or plasma being excited by electromagnetic (EM) radiation. When these atoms absorb energy, they become excited and subsequently release energy as they return to their original state. This emitted light, or "fluorescence," is observed at a right angle to the incident beam. Both absorption and emission processes transpire at distinct wavelengths, which...
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Intraoperative fluorescence imaging in thoracic surgery.

Andrew D Newton1, Jarrod D Predina1, Shuming Nie2

  • 1Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.

Journal of Surgical Oncology
|August 12, 2018
PubMed
Summary

Intraoperative fluorescence imaging (IFI) enhances real-time cancer cell detection in thoracic surgery. Agents like indocyanine green and OTL38 show promise in identifying various thoracic tumors, improving surgical precision.

Keywords:
OTL38indocyanine green (ICG)intraoperative fluorescence imaging (IFI)near-infrared (NIR) fluorescence imagingthoracic surgery

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Area of Science:

  • Surgical Oncology
  • Medical Imaging
  • Thoracic Surgery

Background:

  • Intraoperative fluorescence imaging (IFI) offers real-time visualization during surgery.
  • Current methods for identifying small thoracic tumors can be challenging.
  • Specific imaging agents can enhance tumor detection and characterization.

Purpose of the Study:

  • To review preclinical and clinical data on intraoperative fluorescence imaging in thoracic surgery.
  • To evaluate the efficacy of different fluorescence imaging agents.
  • To highlight the potential of IFI in improving thoracic cancer surgery.

Main Methods:

  • Review of existing preclinical studies on IFI in thoracic models.
  • Analysis of Phase I clinical trial data for IFI in thoracic surgery.
  • Evaluation of fluorescence imaging agents including indocyanine green (TumorGlow®) and OTL38.

Main Results:

  • IFI successfully identified subcentimeter pulmonary nodules, anterior mediastinal masses, and mesothelioma in Phase I trials.
  • Indocyanine green demonstrated utility in visualizing various thoracic malignancies.
  • Folate receptor-targeted agent OTL38 improved diagnostic specificity for folate receptor-expressing tumors.

Conclusions:

  • Intraoperative fluorescence imaging is a promising technology for thoracic surgery.
  • Specific agents enhance the identification and characterization of thoracic tumors.
  • IFI has the potential to improve surgical outcomes and precision in cancer resections.