HEALTHCARE g


images signals in the near-infrared range. Combining the localisation of specific labelling agents with a true colour image of a surgical site can provide useful information during surgery. Applications in medicine for systems like


this include tumour diagnosis. As tumours manifest and grow the cells start to produce new blood vessels in order to feed their metabolic needs. However, some of these vessels can suffer from low perfusion, which can be picked up by a system like the Spectrum. Richard Meester, CEO of Quest Medical


Imaging, commented: ‘Providing surgeons with visual aids to detect cancerous lesions through a real-time imaging platform will improve patient care and get us one step closer to achieving our mission of fighting cancer with light and improving patient outcomes.’


Vision in green As part of the diagnostic process, a tumour patient is injected with indocyanine green (ICG). Tis accumulates in blood vessels, but remains for longer in tumour- induced vessels, which is then seen by the multispectral camera. It is also possible to diagnose liver


metastases using this technology in a similar way, while potential future uses include detecting the sentinel lymph node to improve speed and accuracy in finding the lymphatic channel and nodes. Tis could also result in the surgeon making smaller incisions and speeding up the entire procedure. Once again, this involves injecting a fluorescent tracer such as ICG into the tumour region, which, used alongside the multispectral camera, allows mapping of the tumour drainage lymphatic system, including nodes and veins. A biopsy of the sentinel lymph node can then be taken for cancer staging. Translating into real-life use cases,


Vision technology for healthcare applications requires highly precise processes


the Leiden University Medical Centre (LUMC) in the Netherlands last year saw a team from its Toracic Surgery and Surgery departments, alongside the Centre for Human Drug Research, remove a lung tumour, which was detected using fluorescence imaging in what was believed to be the first instance in Europe of using this technique on a lung tumour patient. It had previously been successfully applied to patients with ovarian cancer. Prior to surgery, the patient was injected


with OTL38 – a compound developed by American firm On Target Technologies – consisting of a folic acid-targeting molecule linked to an NIR dye. Te compound attaches itself to tumour cells in the body, allowing the surgeon to see the tumour and the possibly affected lymph nodes using Quest’s NIR camera. Dr Jerry Braun, cardio-


thoracic surgeon at the LUMC, who co- performed the operation, stated: ‘Identifying the malignant tissue is sometimes difficult. You can’t always see it with the naked eye. You can’t feel it during a viewing operation either.’


Rapid recovery As well as enabling the identification and removal of malignant tissue, this technology can reduce the chance of discovering, post- surgery, that not all of the tumour tissue has been removed. What’s more, the technique actually helps save tissue, so there is less risk and potentially the patient recovers better. Braun continued: ‘Metastases are not


always visible on a CT scan, especially if they are small or are directly on the pleura. Tis fluorescence technique is still under development in Leiden and is frequently used in research. Te first results with lung surgery are promising. As a result, we can hopefully operate more minimally invasively and with good results.’ Meester added: ‘Adjusting our technology


to support OTL38 and participate in a phase three clinical trial is an important step for our Spectrum fluorescence imaging platform.’ Quest also teamed up with biotechnology


Fluorescence imaging can visualise biological structures with fluorescent labelling 24 IMAGING AND MACHINE VISION EUROPE DECEMBER 2019/JANUARY 2020


firm SurgiMab in 2017 in the latter’s development of cancer-specific fluorescent molecules for use in fluorescence-guided oncologic surgery and colorectal cancer (CRC). Te partnership formed as SurgiMab was about to begin the phase three clinical trial of its SGM-101 tumour-specific antibody conjugated to a near-infrared fluorochrome.


@imveurope | www.imveurope.com


Quest Imaging


Berliner Glas


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