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Updated: Dec 24, 2025
Tissue-simulating Phantoms for Assessing Potential Near-infrared Fluorescence Imaging Applications in Breast Cancer Surgery
Published on: September 19, 2014
Comparison of detection sensitivity of near infrared (NIR) surgical imaging systems using a connective tissue phantom
Hira Shahzad Sardar1, Qais Zai2, Jason Gunn1
1Thayer School of Engineering, Dartmouth College, Hanover, NH 03755, USA.
Abstract:
Many tumors for which fluorescence guided surgery (FGS) has been developed are surface tumors, where direct visualization by the surgeon is straightforward. On the other hand, cancers such as soft-tissue sarcomas, are present at a subsurface level. Resection of these sub-surface tumors is performed using 'wide local excision' where a single, complete mass is removed with an intact zone of normal tissue (~ 1 cm 'margin'). We used a phantom model for sarcoma with near infrared fluorophore IRDye800 CW that defined different tissue properties. We compare the detection sensitivity of two commercially available near infrared (NIR) surgical imaging systems, Solaris (Perkin Elmer) and SPY PHI (Novadaq) using the phantom models of sarcoma. We also determine targeted fluorescence signal on both systems for blinded surgical phantom dissection by a surgeon. The fluorescence intensities are higher for Solaris than for SPY-PHI. On average, the fluorescence increased with an increase in intralipid concentration and decreased with an increase in blood concentration. The depth of imaging was higher for Solaris than for SPY PHI. Using the target values, the surgeon successfully dissected all phantoms using Solaris. Using fat phantoms for SPY PHI, the surgeon cut through four out of the total. Further improvement in FGS will improve cancer recurrence and morbidity.
Insights
This study compared two near-infrared (NIR) surgical imaging systems for detecting subsurface tumors. Solaris demonstrated superior sensitivity and imaging depth compared to SPY PHI, enabling more accurate phantom dissections for fluorescence-guided surgery (FGS).
Area of Science:
- Surgical Oncology
- Medical Imaging
- Biomedical Engineering
Background:
- Surface tumors are amenable to fluorescence-guided surgery (FGS), but subsurface cancers like soft-tissue sarcomas pose challenges.
- Wide local excision is the standard for subsurface tumor removal, requiring precise identification of tumor margins.
- Near-infrared (NIR) fluorescence imaging offers potential for enhanced visualization of subsurface tumors.
Purpose of the Study:
- To compare the detection sensitivity and imaging depth of two commercial NIR surgical imaging systems (Solaris and SPY PHI) using sarcoma phantom models.
- To determine optimal fluorescence signal thresholds for accurate phantom dissection.
- To evaluate the impact of tissue optical properties on NIR imaging performance.
Main Methods:
- Development of phantom models simulating sarcoma tissue with varying concentrations of intralipid and blood.
- Utilized IRDye800 CW as a near-infrared fluorophore.
- Compared Solaris and SPY PHI imaging systems for fluorescence intensity and imaging depth.
- Conducted blinded phantom dissections by a surgeon using determined target fluorescence values.
Main Results:
- Solaris exhibited higher fluorescence intensities and greater imaging depth compared to SPY PHI.
- Fluorescence signal increased with intralipid concentration and decreased with blood concentration.
- The surgeon successfully dissected all phantoms using Solaris with target values, but encountered errors with SPY PHI on fat phantoms.
Conclusions:
- Solaris demonstrates superior performance for subsurface tumor detection in phantom models compared to SPY PHI.
- Optimized fluorescence-guided surgery (FGS) has the potential to reduce cancer recurrence and patient morbidity.
- Further advancements in FGS technology are crucial for improving surgical outcomes in subsurface cancer resection.
