Image-guided cancer surgery : the value of near-infrared fluorescence imaging during oncologic and gastrointestinal procedures

Intraoperative imaging using near-infrared (NIR) fluorescence is a relatively new technique that can be used to visualize tumor tissue, sentinel nodes and vital anatomical structures. This thesis is divided in three parts. In part one the ability to visualize surgical margins using NIR fluorescence imaging is demonstrated. Tumor visualization is established using the clinically approved contrast agent indocyanine green, as well as newly developed tumor targeted probes. The proportion of laparoscopic procedures has steadily increased over the last two decades. A challenging aspect of this conversion to minimal invasive surgery is the lack of tactile information, making it of particular interest for the development and improvement of laparoscopic NIR fluorescence imaging systems. Part two focusses on the clinical implementation of NIR fluorescence guided sentinel lymph node mapping for several indications (e.g. breast, skin and vulvar cancer). Besides visualization of structures that need to be resected (e.g. tumor tissue or sentinel nodes), NIR fluorescence has also the potential to be of value for the identification of structures that should be spared. In part three, we demonstrate the first-in-human application of NIR fluorescence guided ureteral visualization, and also the optimization of bile duct imaging for routine laparoscopic cholecystectomies.Dutch Cancer Society (UL 2010-4732), the Center for Translational Molecular Medicine (CTMM, DeCoDe and MUSIS projects) and the Leiden University Fund/Piso KuperusUBL - phd migration 201

Intraoperative fluorescence imaging to localize tumors and sentinel lymph nodes in rectal cancer

Surgical oncolog

Real-time near-infrared fluorescence guided surgery in gynecologic oncology: A review of the current state of the art

Surgical oncolog

Near-infrared fluorescence sentinel lymph node mapping in breast cancer: A multicenter experience

Surgical oncolog

First Experience on Laparoscopic Near-Infrared Fluorescence Imaging of Hepatic Uveal Melanoma Metastases Using Indocyanine Green

Surgical oncolog

Expression of uPAR in tumor-associated stromal cells is associated with colorectal cancer patient prognosis: a TMA study

Surgical oncolog

Ex vivo sentinel node mapping in colon cancer combining blue dye staining and fluorescence imaging

Surgical oncolog

Laparoscopic near-infrared fluorescence imaging of hepatic uveal melanoma metastases using indocyanine green: A technical note

Transplant surger

Intraoperative Near Infrared Fluorescence Guided Identification of the Ureters Using Low Dose Methylene Blue: A First in Human Experience

Cervix cance

Real-time intraoperative detection of breast cancer using near-infrared fluorescence imaging and Methylene Blue

Surgical oncolog