• Neurospine
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• v.15 no.4
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• pp.306-322
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• 2018

This review introduces the current technique of photoacoustic imaging as it is applied in imaging-guided surgery (IGS), which provides the surgeon with image visualization and analysis capabilities during surgery. Numerous imaging techniques have been developed to help surgeons perform complex operations more safely and quickly. Although surgeons typically use these kinds of images to visualize targets hidden by bone and other tissues, it is nonetheless more difficult to perform surgery with static reference images (e.g., computed tomography scans and magnetic resonance images) of internal structures. Photoacoustic imaging could enable real-time visualization of regions of interest during surgery. Several researchers have shown that photoacoustic imaging has potential for the noninvasive diagnosis of various types of tissues, including bone. Previous studies of the surgical application of photoacoustic imaging have focused on cancer surgery, but photoacoustic imaging has also recently attracted interest for spinal surgery, because it could be useful for avoiding pedicle breaches and for choosing an appropriate starting point before drilling or pedicle probe insertion. This review describes the current instruments and clinical applications of photoacoustic imaging. Its primary objective is to provide a comprehensive overview of photoacoustic IGS in spinal surgery.

• Medical Lasers
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• v.10 no.3
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• pp.123-131
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• 2021

Optical imaging modalities with properties of real-time, non-invasive, in vivo, and high resolution for image-guided surgery have been widely studied. In this review, we introduce two optical imaging systems, that could be the core of image-guided surgery and introduce the system configuration, implementation, and operation methods. First, we introduce the optical coherence tomography (OCT) system implemented by our research group. This system is implemented based on a swept-source, and the system has an axial resolution of 11 ㎛ and a lateral resolution of 22 ㎛. Second, we introduce a fluorescence imaging system. The fluorescence imaging system was implemented based on the absorption and fluorescence wavelength of indocyanine green (ICG), with a light-emitting diode (LED) light source. To confirm the performance of the two imaging systems, human malignant melanoma cells were injected into BALB/c nude mice to create a xenograft model and using this, OCT images of cancer and pathological slide images were compared. In addition, in a mouse model, an intravenous injection of indocyanine green was used with a fluorescence imaging system to detect real-time images moving along blood vessels and to detect sentinel lymph nodes, which could be very important for cancer staging. Finally, polarization-sensitive OCT to find the boundaries of cancer in real-time and real-time image-guided surgery using a developed contrast agent and fluorescence imaging system were introduced.

• Journal of the Microelectronics and Packaging Society
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• v.21 no.4
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• pp.25-31
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• 2014

Bioimaging has advanced the field of nanomedicine, drug delivery, and tissue engineering by directly visualizing the dynamic mechanism of diagnostic agents or therapeutic drugs in the body. In particular, wide-field, planar, near-infrared (NIR) fluorescence imaging has the potential to revolutionize human surgery by providing real-time image guidance to surgeons for target tissues to be resected and vital tissues to be preserved. In this review, we introduce the principles of NIR fluorescence imaging and analyze currently available NIR fluorescence imaging systems with special focus on optical source and packaging. We also introduce the evolution of the FLARE intraoperative imaging technology as an example for image-guided surgery.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.395-399
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• 2022

A 6-year-old spayed, female golden retriever dog was presented with a skin mass on the dorsal region of the right carpus. The cytology result of the region revealed characteristics of mast cell tumors (MCTs). Short wave-infrared fluorescence-guided surgery using Indocyanine green (ICG) was performed to determine the surgical margin of the tumor. ICG was injected intravenously 24 hours before the surgery and the patient was hospitalized and carefully monitored. During the surgery, ICG fluorescence-based surgery was performed to identify the tumor and the surgical margin. The tumor was visible, and the skin mass was resected using NIR device for the guidance of the surgical margin of the tumor. Once the resection was complete, the surgical site was again inspected with SWIR fluorescence imaging to identify residual tumor cells. The resected tumor, using ICG navigation, was classified as low-grade cutaneous MCT and the margin was complete on the histopathological result. We report herein a case of resection of a cutaneous MCT in a dog using SWIR fluorescence imaging ICG which can be potentially used for the identification of tumors and evaluation of the surgical margin for complete resection.

• Journal of the Microelectronics and Packaging Society
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• v.27 no.4
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• pp.107-111
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• 2020

Recently, as an aging society progresses, a lot of interest in health and diagnosis is increasing, As the field of various bio-imaging systems for guided surgery capable of accurate diagnosis has emerged as important, a Fluorescence imaging system capable of accurate measurement and real-time confirmation has emerged as an important field. Fluorescence images currently being used are mainly in the NIR-I band, but many studies are in progress in the NIR-II band in order to improve resolution and confirm fluorescence deeply and accurately. In this paper, the difference between NIR-I and NIR-II, optical characteristics, and SBR (signal to background ration) of a fluorescent imaging system, was investigated using the finite element (FEM) method. After confirming, it was confirmed that the SBR was 16.2 times higher in the NIR-II area than in the NIR-I by making the skin phantom and measuring the fluorescence. It is confirmed that the enhancement in SBR of the Fluorescence imaging system is more effective in the NIR-II region than in the NIR-I region and expected to be used in application fields such as guided surgery, bio-sensor and also device which can detect the defect of optical devices.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1715-1718
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• 2015

Background: Magnetic resonance imaging of breast, reported to be a high sensitivity of 94% to 100%, is the most sensitive method for detection of breast cancer. The purpose of this study was to investigate our clinical experience in MRI-guided breast lesion wire localization in Chinese women. Materials and Methods: A total of 44 patients with 46 lesions undergoing MRI-guided breast lesion localization were prospectively entered into this study between November 2013 and September 2014. Samples were collected using a 1.5-T magnet with a special MR biopsy positioning frame device. We evaluated clinical lesion characteristics on pre-biopsy MRI, pathologic results, and dynamic curve type baseline analysis. Results: Of the total of 46 wire localization excision biopsied lesions carried out in 44 female patients, pathology revealed fourteen malignancies (14/46, 30.4%) and thirty-two benign lesions (32/46, 69.6%). All lesions were successfully localized followed by excision biopsy and assessed for morphologic features highly suggestive of malignancy according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) category of MRI (C4a=18, C4b=17, C4c=8,C5=3). Of 46 lesions, 37 were masses and 9 were non-mass enhancement lesions. Thirty-two lesions showed a continuous kinetics curve, 11 were plateau and 3 were washout. Conclusions: Our study showed success in MRI-guided breast lesion wire localization with a satisfactory cancer diagnosis rate of 30.4%. MRI-guided wire localization breast lesion open biopsy is a safe and effective tool for the workup of suspicious lesions seen on breast MRI alone without major complications. This may contribute to increasing the diagnosis rate of early breast cancer and improve the prognosis in Chinese women.

• Archives of Craniofacial Surgery
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• v.17 no.1
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• pp.14-19
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• 2016

Background: Most nasal bone fractures are corrected using non-invasive methods. Often, patients are dissatisfied with surgical outcomes following such closed approach. In this study, we compare surgical outcomes following blind closed reduction to that of ultrasound-guided reduction. Methods: A single-institutional prospective study was performed for all nasal fracture patients (n=28) presenting between May 2013 and November 2013. Upon research consent, patients were randomly assigned to either the control group (n=14, blind reduction) or the experimental group (n=14, ultrasound-guided reduction). Surgical outcomes were evaluated using preoperative and 3-month postoperative X-ray images by two independent surgeons. Patient satisfaction was evaluated using a questionnaire survey. Results: The experimental group consisted of 4 patients with Plane I fracture and 10 patients with Plane II fracture. The control group consisted of 3 patients with Plane I fracture and 11 patients with Plane II fracture. The mean surgical outcomes score and the mean patient dissatisfaction score were found not to differ between the experimental and the control group in Plane I fracture (p=0.755, 0.578, respectively). In a subgroup analysis consisting of Plane II fractures only, surgeons graded outcomes for ultrasound-guided reduction higher than that for the control group (p=0.007). Likewise, among the Plane II fracture patients, those who underwent ultrasound-guided reduction were less dissatisfied than those who underwent blind reduction (p=0.043). Conclusion: Our study result suggests that ultrasound-guided closed reduction is superior to blind closed reduction in those patients with Plane II nasal fractures.

• Investigative Magnetic Resonance Imaging
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• v.20 no.1
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• pp.61-65
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• 2016

Osteoid osteoma, a frequent lesions of bone, is usually intraosseous but occasionally subperiosteal. We describe the case of a 19-year-old male with knee pain caused by subperiosteal osteoid osteoma. Radiologic evaluation was performed with radiographic, computed tomography (CT), ultrasonographic (US) and magnetic resonance imaging (MRI). But the preoperative diagnosis of osteoid osteoma was delayed because of unusual imaging findings and atypical symptom. After excisional biopsy, histological examination confirmed the diagnosis of osteoid osteoma. The lesion was treated successfully with CT-guided radiofrequency ablation.

• Progress in Medical Physics
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• v.31 no.3
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• pp.35-53
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• 2020

The authors congratulate the cerebrations for the 30 years of the Korean Society of Medical Physics (http://www.ksmp.or.kr/). The paper is published to recognize the anniversary. Geon-Ho Jahng invited Professor Z. H. Cho to join to submit this manuscript because he has been one of the leaders in the field of magnetic resonance imaging (MRI) during the last 40 years. In this review, we describe the development and clinical histories of MRI internationally and domestically. We also discuss diffusion and perfusion MRI, molecular imaging using MRI and MR spectroscopy (MRS), and the hybrid systems, such as positron emission tomography-MRI (PET-MRI), MR-guided focused ultrasound surgery (MRgFUS), and MRI-guided linear accelerators (MRI-LINACs). In each part, we discuss the historical evolution of the developments, technical developments, and clinical applications.

• Clinics in Shoulder and Elbow
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• v.25 no.2
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• pp.140-144
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• 2022

Background: Ultrasound (US)-guided techniques reported for the treatment of calcific tendinitis have mostly demonstrated good results. This study investigates the effect of US-guided barbotage using a spinal needle in patients with calcific tendinitis of the shoulder. Methods: Thirty-six patients with calcific tendinitis of the shoulder treated by US-guided barbotage with a spinal needle and subacromial steroid injection were included in the study. We evaluated clinical outcomes based on American Shoulder and Elbow Surgeons (ASES) score, Constant score, and visual analog scale (VAS) for pain score. Radiological outcomes were assessed by X-ray imaging at each visit. Results: Our results showed that US-guided barbotage and subacromial steroid injection produced good clinical and radiological outcomes in patients with calcific tendinitis of the shoulder. Of the 36 patients, only one required surgical treatment, while the others showed improvement without any complications. Compared to values before the procedure, calcific deposit size and VAS, ASES, and Constant scores showed significant improvement 6 weeks after the procedure. No significant correlation was found between the initial calcific deposit size and clinical outcomes at each time point. Conclusions: In patients with calcific tendinitis of the shoulder, US-guided barbotage using a spinal needle and subacromial steroid injection can yield satisfactory clinical and radiological results.