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Archive November 2019 XX, No. 11

The Promise of Near-Infrared Fluorescence

The imaging technology provides valuable visual information to the surgeon that even the brightest white light can't match.

Joe Paone

Joe Paone


COMPARE AND CONTRAST Near-infrared fluorescence lets surgeons distinguish healthy tissue from unhealthy tissue by presenting them in different colors.

If your surgeons are asking for near-infrared fluorescence imaging, you might be wondering what the technology is used for and whether it makes sense to add it to your ORs. Let’s find out.

What does it do?

The bright white light on laparoscopic and robotic cameras that transmits images to surgical monitors from inside the body can brighten up a dark cavity, but beyond brightness it doesn’t provide any additional assistance or usable information to the surgeon. The ultra-high resolution of a 4K monitor can definitely enhance the quality of visualization, but on its own it doesn’t assist the surgeon beyond showing a very crisp real-life picture.

That’s where the more intelligent visualization offered by near-infrared fluorescence imaging can provide a tremendous assist to the surgeon. Using invisible near-infrared light, it identifies and delineates areas of interest. It can, for example, help a surgeon distinguish unhealthy tissue from healthy tissue through enhanced color contrast. The technology can contribute to surgeons performing more confident, accurate and comprehensive procedures, especially those involving the identification and removal of cancerous tumors. “Surgeons don’t have anything to guide them through the surgical resection of bad tissue,” says Maged Henary, PhD, an associate professor of chemistry and associate director of graduate studies at Georgia State University in Atlanta. “Sometimes surgeons like to cut a larger amount of tissue than is necessary. They don’t know really how many small parts of the tumor may have been left behind.”

Invisible to the naked eye, near-infrared light provides “lighting” for the surgeon that visible white light can’t. That lighting is enabled by a contrast agent, or fluorophore. The wavelength of the near-infrared light excites the contrast agent that has bonded with the tissue. Malignant tissue fluoresces differently than benign tissue. The imaging system can then overlay easily distinguishable colors onto a normal operative view that highlights critical areas.

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