Purpose: Near-infrared (NIR) fluorescence imaging can provide the surgeon with real-time visualization of, e.g., tumor margins and lymph nodes. We describe and evaluate the Artemis, a novel, handheld NIR fluorescence camera.Procedures: We evaluated minimal detectable cell numbers (FaDu-luc2, 7D12-IRDye 800CW), preclinical intraoperative detection of sentinel lymph nodes (SLN) using indocyanine green (ICG), and of orthotopic tongue tumors using 7D12-800CW. Results were compared with the Pearl imager. Clinically, three patients with liver metastases were imaged using ICG.Results: Minimum detectable cell counts for Artemis and Pearl were 2 × 10<sup>5</sup> and 4 × 10<sup>4</sup> cells, respectively. In vivo, seven SLNs were detected in four mice with both cameras. Orthotopic OSC-19-luc2-cGFP tongue tumors were clearly identifiable, and a minimum FaDu-luc2 tumor size of 1 mm<sup>3</sup> could be identified. Six human malignant lesions were identified during three liver surgery procedures.Conclusions: Based on this study, the Artemis system has demonstrated its utility in fluorescence-guided cancer surgery.

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doi.org/10.1007/s11307-014-0799-z, hdl.handle.net/1765/89610
Molecular Imaging and Biology
Department of Otorhinolaryngology

van Driel, P.B.A.A, van de Giessen, M, Boonstra, M.C, Snoeks, T.J.A, Keereweer, S, Oliveira, S, … Dijkstra, J. (2015). Characterization and Evaluation of the Artemis Camera for Fluorescence-Guided Cancer Surgery. Molecular Imaging and Biology, 17(3), 413–423. doi:10.1007/s11307-014-0799-z