<i>GTx-Eyes</i> 3D-navigation system.

<p>(a), virtual cutting guide (red line) displayed on a CT reconstruction of the Sawbones mandible model, with navigated reciprocating saw correctly aligned (the saw blade is green) [bone anterior to the plane of the saw blade is clipped in the image so that the osteotomy plane can be visualized through the bone]; (b), the indicators of distance, pitch and roll move and change color from red to yellow then green as the navigated saw is aligned precisely with the virtual cutting guide; (c), the saw blade also turns from red to yellow then green as it is lined up correctly; (d), virtual cutting guide (red line) and unnavigated and 3D-navigated osteotomies (blue lines) after the analysis of multiple osteotomized models.</p

Differences in distance, pitch and roll between the virtually planned osteotomy and the unnavigated and 3D-navigated osteotomies.

<p>Differences in distance, pitch and roll between the virtually planned osteotomy and the unnavigated and 3D-navigated osteotomies.</p

Box-and-whisker plots showing the distance, pitch and roll of the unnavigated and 3D-navigated osteotomies.

<p>Bars denote median, boxes show interquartile range (IQR), upper whiskers show third quartile plus 1.5 IQR, and lower whiskers show first quartile minus 1.5 IQR.</p

Planned osteotomies in Sawbones mandible and maxilla.

<p>Planned osteotomies in Sawbones mandible and maxilla.</p

Injection volume was optimized using <i>ex vivo</i> porcine lungs.

<p>(A) The lung cross sections showed the dimensions of injected ICG (100 μg/ml, paired with 5%BSA) which depended on the volume of the injection. Scale bars show 10 mm. (B) ICG injection of 1,000 μL resulted in significantly larger ICG florescence area compared to the other 2 doses (*p = 0.0033, Kruskal-Wallis). Each box consists of both sides of cross sections of 3 lungs (n = 6).</p

Multiple factors determine the ICG fluorescence intensity.

<p>(A) Autologous porcine plasma (PL) and 5% bovine serum albumin (BSA) enhanced the ICG fluorescence intensity, with the brightest intensity at 10 μg/ml (at 3cm). Top: normal images, middle: merged images, bottom: fluorescence images. (B, C) Fluorescence intensity depended on the distance from the objects. ICG was paired with PL.</p

Successful sentinel lymph node detection using the near-infrared fluorescence imaging.

<p>One of the subcarinal lymph nodes was successfully identified as a sentinel lymph node immediately after transpleural ICG injection (100 μg/ml, 100 μL) into the right lower lobe. The afferent lymph vessel was clearly visualized as well, showing a high contrast when compared to the background. Left: merged images, Right: fluorescence images.</p

Successful sentinel lymph node identification after pre-operative tansbronchial ICG injection.

<p>Electro-magnetic navigational bronchoscopy-guided transbronchial ICG injection (100 μg/ml, 100 μL) into the left lower lobe enabled the SN node identification by the NIR thoracoscope. (A) The left paratracheal lymph node was recognized as the SN. Left top: intraoperative NIR image, left bottom: <i>ex vivo</i> examination of the SN, right: <i>ex vivo</i> examination of the lymph node cross sections which showed select bright portions. Asterisk shows hemi-azygos vein. (B) The navigation guidance led the bronchoscope to the target accurately. The scale bar shows 10 mm.</p