The Quest Spectrum® can be used for visualization of tumors. Tumors are known for their rapid proliferation and increased energy consumption. In order to feed their increased metabolic needs, the tumor cells induce angiogenesis. The new blood vessels increase the blood flow to the tumors. However, some of these vessels can suffer from lower perfusion. These blood vessels can be visualized with help of the Quest Spectrum.

In order to visualize the blood vessels surrounding a tumor a patient is injected with Indocyanine Green (ICG). ICG accumulates in all blood vessels of the targeted tissue making all blood vessels visible using fluorescent imaging. When the injection of ICG is stopped, the ICG concentration in healthy blood vessels decreases rapidly, while the concentration in tumor induced blood vessels decreases more slowly. This contrast can be visualized and used by Quest Spectrum for tumor localization.

 

visualization

 

Visualization of liver metastasis

Visualization of liver metastases with the Quest Spectrum is shown above. On the left is the true color image which the surgeon can see with the naked eye. On the right, the fluorescent response of the ICG tracer is shown. This image shows four circular shaped structures. The middle image overlays the fluorescent image in green upon the natural image. In this image the tumors are clearly visualized, which shows the efficacy of fluorescent imaging with the Quest Spectrum. Surgeons can make better real-time decisions in the operating room with the help of the Quest Spectrum.

 

Colorectal cancer liver metastasis

The video below shows the application of the Quest Spectrum for the detection of colorectal cancer liver metastasis. After the injection of ICG the metastases are visible as green rings around the metastasis. This procedure can be performed either open or laparoscopically.

 

 

Near-infrared fluorescent imaging identifies significantly more and smaller tumors during resection of colorectal cancer liver metastasis, which we believe may prevent recurrences in a subset of patients.

 

Links to supporting literature:

Near-infrared fluorescence-guided resection of colorectal liver metastases.

Van der Vorst et al.,

Cancer 2013. Sep 15 ;119(18):3411-8

 

Long-term follow-up after near-infrared fluorescence-guided resection of colorectal liver metastases: A retrospective multicenter analysis

Handgraaf et al.

European Journal of Surgical Oncology , Volume 43 , Issue 8 , 1463 – 1471

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