Intraoperative Near-Infrared Imaging Can Identify Pulmonary Nodules

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Intraoperative Near-Infrared Imaging Can Identify Pulmonary Nodules Olugbenga T. Okusanya, MD, David Holt, BVSc, Daniel Heitjan, PhD, Charuhas Deshpande, MD, Ollin Venegas, BA, Jack Jiang, BS, Ryan Judy, BA, Elizabeth DeJesus, BA, Brian Madajewski, BA, Kenny Oh, BA, May Wang, PhD, Steven M. Albelda, MD, Shuming Nie, PhD, Sunil Singhal, MD The Annals of Thoracic Surgery Volume 98, Issue 4, Pages 1223-1230 (October 2014) DOI: 10.1016/j.athoracsur.2014.05.026 Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Patient No. 3: A 64-year-old female presented with an 18fluorodeoxyglucose-avid (standard uptake value 9.3) 6 cm right upper lobe tumor. (A) Computed tomographic scan; (B) positron emission tomographic scan with red arrows denoting cancer; (C) conventional camera; (D) near-infrared camera; (E) near-infrared heat map; (F) fluorescence; (G) hematoxylin & eosin at 100× magnification; (H) 780 nm light source; (I) microscopic overlay. The Annals of Thoracic Surgery 2014 98, 1223-1230DOI: (10.1016/j.athoracsur.2014.05.026) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Patient No. 12: A 29-year-old male presented with an 18fluorodeoxyglucose-avid (standard uptake value 7) 2.7 cm right upper lobe tumor. (A) Computed tomographic scan; (B) positron emission tomographic scan with red arrows denoting cancer; (C) conventional camera; (D) near-infrared camera; (E) near-infrared heat map; (F) fluorescence; (G) hematoxylin & eosin and 100× magnification; (H) 780 nm light source; (I) microscopic overlay. The Annals of Thoracic Surgery 2014 98, 1223-1230DOI: (10.1016/j.athoracsur.2014.05.026) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Overview of results from near-infrared imaging study. The Annals of Thoracic Surgery 2014 98, 1223-1230DOI: (10.1016/j.athoracsur.2014.05.026) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 (A) In situ, fluorescent nodules are more likely to be closer to the pleural surface (p = 0.044). (B) Smaller nodules (<2 cm) trended toward less fluorescence but this did not reach statistical significance nor did it have clinical impact. (C) There is no correlation of microvascular density (CD31 staining) to degree of fluorescence. The Annals of Thoracic Surgery 2014 98, 1223-1230DOI: (10.1016/j.athoracsur.2014.05.026) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions