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Cameras in the operating theatre that see dyes the surgeon's eye cannot: green dye lighting up lymph nodes and blood supply, pink glow marking a brain tumour, and even the faint light from a PET tracer in a removed specimen. They turn the dyes into a picture the surgeon follows.
Fluorescence-guided surgery depends on the camera as much as the dye. Near-infrared systems excite indocyanine green at about 800 nm and overlay its glow on the white-light view: Stryker's SPY Elite and the handheld SPY-PHI, descended from Novadaq, and its 1688 AIM laparoscopes; Karl Storz's Rubina and Olympus's Visera Elite III IR laparoscopes; the Firefly mode on Intuitive's da Vinci; Medtronic's Elevision and the Hamamatsu PDE-neo handheld. They map sentinel lymph nodes, check bowel and flap perfusion, define liver segments and find ureters and bile ducts. Surgical microscopes from Zeiss and Leica add filters for 5-aminolevulinic acid's pink porphyrin glow in high-grade glioma (Blue 400), for fluorescein (Yellow 560) and for indocyanine green angiography. Tumour-targeted agents have brought dedicated cameras: pafolacianine for ovarian and lung cancer runs on near-infrared endoscopes, and Lumicell's LumiSystem, approved in 2024 with pegulicianine, scans the lumpectomy cavity for residual breast cancer. Cerenkov luminescence imaging captures the faint blue light that positron emitters give off in tissue; Lightpoint Medical's LightPath images a freshly excised prostate specimen after a gallium-68 PSMA injection to check the margins, and the same company's SENSEI drop-in gamma probe brings radioguided node detection to robotic surgery.
Against frozen-section pathology and the naked eye, fluorescence is immediate and covers the whole field, but it sees only a few millimetres deep, depends on the dye reaching the tissue, has few approved tumour-specific agents, and evidence that it improves survival, rather than margins or node detection, is still thin.
Excitation light at a dye's absorption band and filtered cameras detect near-infrared or visible fluorescence from perfusion, lymphatic or tumour-targeted agents in the surgical field; Cerenkov imaging detects the ultraviolet-blue light emitted by positron-emitting tracers in excised tissue.
Query for this technology: (TITLE:"Intraoperative fluorescence and Cerenkov imaging systems" OR ABSTRACT:"Intraoperative fluorescence and Cerenkov imaging systems" OR TITLE:"SPY, Firefly, LumiSystem, LightPath" OR ABSTRACT:"SPY, Firefly, LumiSystem, LightPath") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Intraoperative fluorescence and Cerenkov imaging systems (SPY, Firefly, LumiSystem, LightPath), not a curated reading list.
Shares Olympus, Medtronic, Optical & fluorescence imaging, Colorectal cancer and the tag machines-wave2.
Shares Gamma probes, handheld gamma cameras and dose calibrators, Sentinel lymph node biopsy, Breast cancer (all types), Melanoma and the tag machines-wave2.
Shares Medtronic, Intraoperative MRI and CT, Glioma & glioblastoma and the tag machines-wave2.
Shares Carl Zeiss Meditec, Optical & fluorescence imaging and the tag machines-wave2.
Shares Hepatocellular carcinoma, Breast cancer (all types), Prostate cancer, Non-small-cell lung cancer and the tag machines-wave2.
Shares Olympus, Colorectal cancer, Non-small-cell lung cancer and the tag machines-wave2.
Shares Breast cancer (all types), Prostate cancer, Non-small-cell lung cancer and the tag machines-wave2.
Shares Hepatocellular carcinoma, Breast cancer (all types), Melanoma and the tag machines-wave2.