Intraoperative near-infrared fluorescence imaging and spectroscopy identifies residual tumor cells in wounds

David Holt, Ashwin B. Parthasarathy, Olugbenga Okusanya, Jane Keating, Ollin Venegas, Charuhas Deshpande, Giorgos Karakousis, Brian Madajewski, Amy Durham, Shuming Nie, Arjun G. Yodh, Sunil Singhal

Research output: Contribution to journalArticlepeer-review


Surgery is the most effective method to cure patients with solid tumors, and 50% of all cancer patients undergo resection. Local recurrences are due to tumor cells remaining in the wound, thus we explore near-infrared (NIR) fluorescence spectroscopy and imaging to identify residual cancer cells after surgery. Fifteen canines and two human patients with spontaneously occurring sarcomas underwent intraoperative imaging. During the operation, the wounds were interrogated with NIR fluorescence imaging and spectroscopy. NIR monitoring identified the presence or absence of residual tumor cells after surgery in 14?15 canines with a mean fluorescence signal-to-background ratio (SBR) of ?16. Ten animals showed no residual tumor cells in the wound bed (mean SBR 2, P 0.001). None had a local recurrence at 1-year follow-up. In five animals, the mean SBR of the wound was 15, and histopathology confirmed tumor cells in the postsurgical wound in four/five canines. In the human pilot study, neither patient had residual tumor cells in the wound bed, and both remain disease free at 1.5-year follow up. Intraoperative NIR fluorescence imaging and spectroscopy identifies residual tumor cells in surgical wounds. These observations suggest that NIR imaging techniques may improve tumor resection during cancer operations.

Original languageEnglish (US)
Article number076002
JournalJournal of biomedical optics
Issue number7
StatePublished - Jul 1 2015
Externally publishedYes


  • indocyanine green fluorescence.
  • intraoperative imaging
  • near-infrared fluorescence imaging
  • optical spectroscopy
  • soft tissue sarcomas
  • surgical margins

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Biomaterials
  • Atomic and Molecular Physics, and Optics
  • Biomedical Engineering


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