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High-sensitive fluorescence endoscope using electrocardiograph-synchronized multiple exposure

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Fluorescence-based measurement of cardiac disease, using autofluorescent substances that already exist in the heart, has not been used for endoscopic surgery because the endoscopic lenses cannot transmit sufficient light. A highly sensitive fluorescence endoscope using an electrocardiograph (ECG)-synchronized multiple exposure (ESME) approach was developed that provides a bright fluorescent image.

Methods

A system was developed consisting of an endoscope, an excitation light, an ECG amplifier, a trigger and delay unit, and a computer. This system is based on periodic motion of the heart. Since the shape of the heart can be photographed by ECG triggering in a similar manner, a bright image can be synthesized by accumulating multiple trigger-captured images. Laboratory and in vivo experiments were performed to confirm the effectiveness of ESME.

Results

The experimental results revealed that the trigger unit generated the synchronization signals required to produce high-quality images of the heart depending on heart rate. The difference among trigger-captured images from the actual organ, which affects the quality of ESME images, was estimated at 0.65 mm from the calculated displacement of a marker on the heart. The results also revealed that a bright fluorescent image can be captured by ESME.

Conclusion

A highly sensitive fluorescence endoscope using ESME was developed and successfully tested. The experimental results indicated that the method enabled high-quality image acquisition in a very low illumination environment. This system is effective for the observation of faint fluorescence in the heart and is useful for the intraoperative examination of the heart status.

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References

  1. Chikwe J, Donaldson J, Wood A (2006) Minimally invasive cardiac surgery. Br Heart J 13(2): 123

    Google Scholar 

  2. Cohn LH, Adams DH, Couper GS, Bichell DP, Rosborough DM, Sears SP, Aranki SF (1997) Minimally invasive cardiac valve surgery improves patient satisfaction while reducing costs of cardiac valve replacement and repair. Ann Surg 226(4): 421–426 (discussion 427–428)

    Article  CAS  PubMed  Google Scholar 

  3. Walther T, Simon P, Dewey T, Wimmer-Greinecker G, Falk V, Kasimir MT, Doss M, Borger MA, Schuler G, Glogar D, Fehske W, Wolner E, Mohr FW, Mack M (2007) Transapical minimally invasive aortic valve implantation: multicenter experience. Circulation 116(11 Suppl): I240–I245. doi:10.1161/CIRCULATIONAHA.106.677237

    PubMed  Google Scholar 

  4. Mohr F, Falk V, Diegeler A, Walther T, Gummert J, Bucerius J, Jacobs S, Autschbach R (2001) Computer-enhanced “robotic” cardiac surgery: experience in 148 patients. J Thorac Cardiovasc Surg 121(5): 842

    Article  CAS  PubMed  Google Scholar 

  5. Pieske B (2004) Reverse remodeling in heart failure-fact or fiction. Eur Heart J Suppl 6(suppl D): 66–78

    Article  Google Scholar 

  6. McKay RG, Pfeffer MA, Pasternak RC, Markis JE, Come PC, Nakao S, Alderman JD, Ferguson JJ, Safian RD, Grossman W (1986) Left ventricular remodeling after myocardial infarction: a corollary to infarct expansion. Circulation 74(4): 693–702

    CAS  PubMed  Google Scholar 

  7. Erlebacher JA, Weiss JL, Eaton LW, Kallman C, Weisfeldt ML, Bulkley BH (1982) Late effects of acute infarct dilation on heart size: a two dimensional echocardiographic study. Am J Cardiol 49(5): 1120–1126

    Article  CAS  PubMed  Google Scholar 

  8. Stummer W, Novotny A, Stepp H, Goetz C, Bise K, Reulen HJ (2000) Fluorescence-guided resection of glioblastoma multiforme by using 5-aminolevulinic acid-induced porphyrins: a prospective study in 52 consecutive patients. J Neurosurg 93(6): 1003–1013

    Article  CAS  PubMed  Google Scholar 

  9. Toms SA, Lin WC, Weil RJ, Johnson MD, Jansen ED, Mahadevan-Jansen A (2005) Intraoperative optical spectroscopy identifies infiltrating glioma margins with high sensitivity. Neurosurgery 57(4 Suppl): 382–391 (discussion 382–391)

    Article  PubMed  Google Scholar 

  10. Madsen SJ, Sun CH, Tromberg BJ, Wallace VP, Hirschberg H (2000) Photodynamic therapy of human glioma spheroids using 5-aminolevulinic acid. Photochem Photobiol 72(1): 128–134

    Article  CAS  PubMed  Google Scholar 

  11. Taggart DP, Choudhary B, Anastasiadis K, Abu-Omar Y, Balacumaraswami L, Pigott DW (2003) Preliminary experience with a novel intraoperative fluorescence imaging technique to evaluate the patency of bypass grafts in total arterial revascularization. Ann Thorac Surg 75(3): 870–873

    Article  PubMed  Google Scholar 

  12. Desai ND, Miwa S, Kodama D, Cohen G, Christakis GT, Goldman BS, Baerlocher MO, Pelletier MP, Fremes SE (2005) Improving the quality of coronary bypass surgery with intraoperative angiography: validation of a new technique. J Am Coll Cardiol 46(8): 1521–1525. doi:10.1016/j.jacc.2005.05.081

    Article  PubMed  Google Scholar 

  13. Fukuhiro Y, Ogasawara Y, Mochizuki S, Ishihara K (2006) In vivo imaging of NADH fluorescence of a rat heart during myocardial ischemia. Institute of Electronics, Information, and Communication Engineers 106: 21–25 (In Japanese)

    Google Scholar 

  14. Ranji M, Matsubara M, Leshnower BG, Hinmon RH, Jaggard DL, Chance B, Gorman RC, Iii JHG (2009) Quantifying acute myocardial injury using ratiometric fluorometry. IEEE Trans Biomed Eng 56(5): 1556–1563. doi:10.1109/TBME.2008.2006029

    PubMed  Google Scholar 

  15. Nakamura Y, Kishi K, Kawakami H (2001) Heartbeat synchronization for robotic cardiac surgery. Proceedings of the international conference on robotics and automation (ICRA):2014–2019

  16. Bebek O, Cavusoglu M Predictive control algorithms using biological signals for active relative motion canceling in robotic assisted heart surgery. Proceedings of the international conference on robotics and automation (ICRA), pp 237–244

  17. Achenbach S, Ulzheimer S, Baum U, Kachelriess M, Ropers D, Giesler T, Bautz W, Daniel WG, Kalender WA, Moshage W (2000) Noninvasive coronary angiography by retrospectively ecg-gated multislice spiral ct. Circulation 102(23): 2823–2828

    CAS  PubMed  Google Scholar 

  18. Lowell DG, Turner DA, Smith SM, Bucheleres GH, Santucci BA, Gresick RJ, Monson DO (1986) The detection of atrial and ventricular septal defects with electrocardiographically synchronized magnetic resonance imaging. Circulation 73(1): 89–94

    CAS  PubMed  Google Scholar 

  19. Greenspan H, Oz G, Kiryati N, Peled S (2002) Mri inter-slice reconstruction using super-resolution. Magn Reson Imaging 20(5): 437–446

    Article  CAS  PubMed  Google Scholar 

  20. Cuvillon L, Gangloff J, de Mathelin M, Forgione A (2005) Toward robotized beating heart TECABG: assessment of the heart dynamics using high-speed vision. Med Image Comput Comput Assist Interv 8(Pt 2): 551–558

    Article  PubMed  Google Scholar 

  21. Liao H, Hata N, Nakajima S, Iwahara M, Sakuma I, Dohi T (2004) Surgical navigation by autostereoscopic image overlay of integral videography. IEEE Trans Inf Technol Biomed 8(2): 114–121

    Article  PubMed  Google Scholar 

  22. Tamaki Y, Akashi-Tanaka S, Ishida T, Uematsu T, Sawai Y, Kusama M, Nakamura S, Hisamatsu K, Tanji Y, Sato Y, Matsuura N (2002) 3D imaging of intraductal spread of breast cancer and its clinical application for navigation surgery. Breast Cancer 9(4): 289–295

    Article  PubMed  Google Scholar 

  23. Yamaguchi S, Nishikawa A, Shimada J, Itoh K, Miyazaki F (2005) Real-time image overlay system for endoscopic surgery using direct calibration of endoscopic camera. Int Congr Ser 1281: 756–761

    Article  Google Scholar 

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Correspondence to Takehiro Ando.

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Ando, T., Taniguchi, K., Kim, H. et al. High-sensitive fluorescence endoscope using electrocardiograph-synchronized multiple exposure. Int J CARS 6, 73–81 (2011). https://doi.org/10.1007/s11548-010-0478-8

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  • DOI: https://doi.org/10.1007/s11548-010-0478-8

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