Peripheral Lung Cancer Detection by Vascular Tumor Labeling Using In-Vivo Microendoscopy under Real Time 3D CT Image Guided Intervention

We designed and evaluated a real time 3D CT Image Guided Intervention system that integrates in-vivo microendoscopic imaging for on-the-spot visualization of ICG contrast uptake by tumor vessel in peripheral lung tumors. The performance of the system was evaluated in seven rabbits where VX2 cells were implanted in the chest to create peripheral lung tumors. Two weeks later the animal underwent a chest CT scan which was used for creating a real time 3D vision and navigation tracking. ICG was injected fifteen minutes prior to the needle puncture to allow adequate contrast leakage inside the tumor and plasma clearance. After the needle puncture, the microendoscope was introduced inside the tumor for imaging. Visualization of tumor leaky vasculature was possible in all the tumors. The experiment demonstrated that real-time microendoscopy of deep solid organs under a 3D CT image-guided system is possible while providing enough accuracy in reaching tumors without complications.