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First-in-human liver-tumour surgery guided by multispectral fluorescence imaging in the visible and near-infrared-I/II windows
Abstract
The second near-infrared wavelength window (NIR-II, 1,000-1,700 nm) enables fluorescence imaging of tissue with enhanced contrast at depths of millimetres and at micrometre-scale resolution. However, the lack of clinically viable NIR-II equipment has hindered the clinical translation of NIR-II imaging. Here, we describe an optical-imaging instrument that integrates a visible multispectral imaging system with the detection of NIR-II and NIR-I (700-900 nm in wavelength) fluorescence (by using the dye indocyanine green) for aiding the fluorescence-guided surgical resection of primary and metastatic liver tumours in 23 patients. We found that, compared with NIR-I imaging, intraoperative NIR-II imaging provided a higher tumour-detection sensitivity (100% versus 90.6%; with 95% confidence intervals of 89.1%-100% and 75.0%-98.0%, respectively), a higher tumour-to-normal-liver-tissue signal ratio (5.33 versus 1.45) and an enhanced tumour-detection rate (56.41% versus 46.15%). We infer that combining the NIR-I/II spectral windows and suitable fluorescence probes might improve image-guided surgery in the clinic.
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“Compounding this issue, significant liver accumulation of these dyes generates intense background fluorescence, further compromising imaging accuracy66.”
From Organic small-molecule NIR-II fluorophores for tumor phototheranostics (2026) · cites this paper as [66]
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Metadata
- Authors
- Hu, Z., Fang, C., Li, B., Zhang, Z., Cao, C., Cai, M., Su, S., Sun, X., Shi, X., Li, C., Zhou, T., Zhang, Y., Chi, C., He, P., Xia, X., Chen, Y., Gambhir, S. S., Cheng, Z., & Tian, J.
- Affiliations
- Chinese Academy of Sciences (CN)
- Southwest Medical University (CN)
- Xidian University (CN)
- Stanford Medicine (US)
- Corresponding author
- Gambhir, Sanjiv Sam
- Cheng, Zhen
- Tian, Jie
- ORCID
- Venue
- Nature Biomedical Engineering
- Published
- 2019-12-23
- Volume
- 4
- Issue
- 3
- Pages
- 259-271
- ISSN
- 2157-846X (ISSN-L)
- OpenAlex
- W2995471545
- Cited by
- 1,126
- References
- 38
- Citations by year
- 2026: 120 · 2025: 197 · 2024: 203 · 2023: 206 · 2022: 179 · 2021: 149 · 2020: 72
- FWCI
- 66.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Nature Biomedical Engineering (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81930053, 61622117, 81671759, 81227901)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Optical Imaging and Spectroscopy Techniques
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biophysics › Spectroscopy Techniques in Biomedical and Chemical Research
- Physical Sciences › Engineering › Biomedical Engineering › Nanoplatforms for cancer theranostics
- Keywords
- NIR-II fluorescence imaging, multispectral imaging, fluorescence-guided surgery, liver tumors, indocyanine green, cancer detection
- MeSH terms
- Animals, Disease Models, Animal, Female, Fluorescence, Carcinoma, Hepatocellular, Humans, Indocyanine Green, Infrared Rays, Liver, Liver Neoplasms, Male, Surgery, Computer-Assisted, Mice, Hep G2 Cells, Optical Imaging
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