Advancing intraoperative magnetic tracing using 3D freehand magnetic particle imaging

作者：S. Azargoshasb, L. Molenaar, Giuseppe Rosiello, T. Buckle, D. V. van Willigen, Melissa M. van de Loosdrecht, M. Welling, L. Alic, F. V. van Leeuwen, A. Winter, M. V. van Oosterom · 发表于：International Journal of Computer Assisted Radiology and Surgery · 年份：2021 · DOI：10.1007/s11548-021-02458-2 · 被引用次数：32 · 研究领域：Computer Science、Medicine

Purpose Sentinel lymph node biopsy is a routine procedure for nodal staging in penile cancer. Most commonly, this procedure is guided by radioactive tracers, providing various forms of preoperative and intraoperative guidance. This is further extended with fluorescence imaging using hybrid radioactive–fluorescence tracers. Alternatively, a magnetic-based approach has become available using superparamagnetic iron-oxide nanoparticles (SPIONs). This study investigates a novel freehand magnetic particle imaging and navigation modality (fhMPI) for intraoperative localization, along with a hybrid approach, combining magnetic and fluorescence guidance. Materials and methods The fhMPI set-up was built with a surgical navigation device, optical tracking system and magnetometer probe. A dedicated reconstruction software based on a look-up-table method was used to reconstruct a superficial 3D volume of the SPION distribution in tissue. For fluorescence guidance, indocyanine green (ICG) was added to the SPIONs. The fhMPI modality was characterized in phantoms, ex vivo human skin and in vivo porcine surgery. Results Phantom and human skin explants illustrated that the current fhMPI modality had a sensitivity of 2.2 × 10 –2  mg/mL SPIONs, a resolving power of at least 7 mm and a depth penetration up to 1.5 cm. Evaluation during porcine surgery showed that fhMPI allowed for an augmented reality image overlay of the tracer distribution in tissue, as well as 3D virtual navigation. Besides, us...