| Near-infrared fluorescence imaging of thoracic duct anatomy and function in open surgery and video-assisted thoracic surgery. | |
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MedLine Citation:
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PMID: 21477818 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Chylothorax resulting from thoracic duct damage is often difficult to identify and repair. We hypothesized that near-infrared fluorescent light could provide sensitive, real-time, high-resolution intraoperative imaging of thoracic duct anatomy and function. METHODS: In 16 rats, 4 potential near-infrared fluorescent lymphatic tracers were compared in terms of signal strength and imaging time: indocyanine green, the carboxylic acid of IRDye 800CW (LI-COR, Lincoln, Neb), indocyanine green adsorbed to human serum albumin, and IRDye 800CW conjugated covalently to human serum albumin. Optimal agent was validated in 8 pigs approaching human size (n = 6 by open surgery with FLARE imaging system [Beth Israel Deaconess Medical Center, Boston, Mass] and n = 2 by video-assisted thoracoscopic surgery minimally invasive [m-FLARE] imaging system [Beth Israel Deaconess Medical Center]). Lymphatic tracer injection site, dose, and timing were optimized. RESULTS: For signal strength, sustained imaging time, and clinical translatability, the best lymphatic tracer was indocyanine green, which is already Food and Drug Administration approved for other indications. In pigs, a simple subcutaneous injection of indocyanine green into lower leg (≥ 36 μg/kg), provided thoracic duct imaging with onset of about 5 minutes after injection, sustained imaging for at least 60 minutes after injection, and signal-to-background ratio of at least 2. With this technology, normal thoracic duct flow, collateral flow, injury models, and repair models could all be observed under direct visualization. CONCLUSIONS: Near-infrared fluorescent light could provide sensitive, sustained, real-time imaging of thoracic duct anatomy and function during both open and video-assisted thoracoscopic surgery in animal models. |
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Authors:
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Yoshitomo Ashitate; Eiichi Tanaka; Alan Stockdale; Hak Soo Choi; John V Frangioni |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2011-04-07 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 142 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-20 Completed Date: 2011-08-19 Revised Date: 2012-09-18 |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 31-8.e1-2 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Division of Hematology/Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass 02215, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Chylothorax / diagnosis*, etiology, pathology Diagnostic Imaging / instrumentation, methods* Fluorescence Fluorescent Dyes / administration & dosage, diagnostic use* Indocyanine Green / administration & dosage, analogs & derivatives, diagnostic use* Infrared Rays / diagnostic use Injections, Subcutaneous Male Monitoring, Intraoperative / instrumentation, methods* Rats Rats, Sprague-Dawley Swine Thoracic Duct / injuries*, pathology Thoracic Surgery, Video-Assisted* / adverse effects, instrumentation Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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#R01-CA-115296/CA/NCI NIH HHS; R01 CA115296-07/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Fluorescent Dyes; 3599-32-4/Indocyanine Green |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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