I-Endoscopy yezoNyango ze-Black Technology (2) i-Molecular Fluorescence Imaging (efana ne-5-ALA/ICG)

Intshayelelo eBanzi kwi-5-ALA/ICG ye-Molecular Fluorescence Imaging Technology kwi-Endoscopy yezoNyango

I-molecular fluorescence imaging yiteknoloji eguqukayo kwinkalo ye-endoscopy yonyango kwiminyaka yamuva nje, efezekisa ukuxilongwa kwexesha lokwenyani kunye nokuchaneka kokubonwayo kunye nonyango ngokubophelela okuthe ngqo kwamanqaku athile e-fluorescent (njenge-5-ALA, ICG) kwizicubu ezigulayo. Oku kulandelayo kubonelela ngohlalutyo olubanzi lwemigaqo yobugcisa, izicelo zeklinikhi, inzuzo yokuthelekisa, iimveliso ezimele, kunye neendlela ezizayo.

1. Imigaqo yobugcisa

(1) Indlela yokusebenza kweziphawuli zefluorescent

(2) Ukuqulunqwa kwenkqubo yokucinga

Umthombo wokukhanya wokuvuselela: Ubude obucacileyo be-LED okanye i-laser (njenge-blue light excitation ye-5-ALA).

Isihluzi se-Optical: sihluza isibane sokuphazamiseka kwaye sibambe kuphela imiqondiso ye-fluorescence.

Ukusetyenzwa komfanekiso: imiqondiso yefluorescent egqume ngaphezulu ngemifanekiso yokukhanya okumhlophe (efana nexesha lokwenyani lokubonisa inkqubo yePINPOINT).

2. Izinto eziluncedo ezingundoqo (vs ne-endoscopy yesikhanyiso esimhlophe)

3. Iimeko zesicelo seklinikhi

(1) 5-ALA fluorescence endoscope

I-Neurosurgery:

Utyando lwe-Glioma lokuqhafaza: I-PpIX fluorescence ileyibhile yemida ye-tumor yonyusa ireyithi yokukhupha i-20% (ukuba ivunyiwe ukuba isetyenziswe ne-GLIOLAN).

Urology:

O Ukuxilongwa komhlaza wesinyi: i-cystoscopy ye-fluorescent (efana neKarl Storz D-LIGHT C) iyanciphisa izinga lokuphindaphinda.

(2) ICG fluorescence endoscope

Uqhaqho lweHepatobiliary:

Utyando lokutshatyalaliswa komhlaza wesibindi: ukuchithwa ngokuchanekileyo kwe-ICG yokugcina iindawo ezintle (ezifana ne-Olympus VISERA ELITE II).

Uqhaqho lwamabele:

I-Sentinel lymph node biopsy: Ukulandelela i-ICG kuthatha indawo ye-isotopes ye-radioactive.

(3) Isicelo esidibeneyo semodal ezininzi

I-Fluorescence+NBI: I-Olympus EVIS X1 idibanisa umfanekiso we-narrowband kunye ne-ICG fluorescence ukuphucula izinga lokuxilonga umhlaza wesisu.

I-Fluorescence + ultrasound: I-ICG yokubhaliswa kwamathumba e-pancreatic ekhokelwa yi-endoscopic ultrasonography (EUS).

4. Ukumela abavelisi kunye neemveliso

5. Imingeni yobugcisa kunye nezisombululo

(1) Ukunciphisa umqondiso weFluorescence

Ingxaki: Ixesha le-5-ALA fluorescence lifutshane (malunga neeyure ze-6).

Isisombululo:

O Ukulawulwa kwe-intraoperative kwiibhetshi (ezifana ne-perfusion eninzi ngexesha lotyando lomhlaza wesinyi).

(2) Ubuxoki obulungileyo / obungalunganga obungalunganga

Ingxaki: Ukudumba okanye ukukrala kwezicubu kungenza impazamo ye-fluorescence.

Isisombululo:

Uhlalutyo lwe-multispectral (njengokwahlula i-PpIX kwi-autofluorescence).

(3) Iindleko kunye ne-Population

Ingxaki: Ixabiso leenkqubo ze-endoscopic ze-fluorescent liphezulu (malunga ne-2 ukuya kwi-5 yezigidi zeeyuan).

Umkhombandlela wokuphumelela:

Ukutshintshwa kwasekhaya (okufana nenkqubo ye-Mindray ME8).

I-endoscope ye-fluorescent elahlayo (efana ne-Ambu aScope ICE).

6. IiNdlela zoPhuhliso lwexesha elizayo

(1) Uphononongo olutsha lwe-fluorescent: Ileyibhile ye-Tumor ethile ye-antibody fluorescent (efana ne-EGFR ejoliswe kwiprobe).

(2) Uhlalutyo lobungakanani be-AI: Ukuhlelwa okuzenzekelayo kokuqina kwe-fluorescence (njengokusebenzisa isoftware yeProSense ukuvavanya ubugwenxa bethumba).

(3) Itekhnoloji yeNanofluorescence: Ukubhalwa kwechaphaza le-Quantum (QDs) kwenza ukuba ufaniso olulungelelanisiweyo olujoliswe kwizinto ezininzi.

(4) Ukuphatheka: I-endoscope ye-fluorescent ephathwayo (efana nesetyenziselwa ukuhlolwa kwizibhedlele zokuqala).

shwankathela

Itekhnoloji yokucinga yemolekyuli ye-fluorescence iyayitshintsha i-paradigm yokuxilongwa kwe-tumor kunye nonyango “ngokubhala okuchanekileyo+ nokuhamba ngexesha lokwenyani”:

Uxilongo: Izinga lokufumanisa umhlaza wokuqala liye landa kakhulu, linciphisa i-biopsies engeyomfuneko.

Unyango: Umda wotyando uchaneke ngakumbi, unciphisa umngcipheko wokuphindaphinda.

Ikamva: Ngokwahluka kweeprobes kunye nokudityaniswa kwe-AI, kulindeleke ukuba ibe sisixhobo esisemgangathweni "se-intraoperative pathology".