Figure 1

Summary of core fluorescence-guided surgery (FGS) technology present in existing FGS systems, examples of existing FGS applications, and breakdown of key components necessary to implement FGS technology with off-the-shelf accessible components. FGS systems excite and detect the fluorescence signal from a fluorophore that accumulates within a tissue of interest and displays this signal to a surgeon to allow them to better visualize structures that are otherwise difficult to see. (A) The key components powering an open-surgery FGS system are reviewed in an example breast tumor excision. Prior to excision, a flurophore that accumulates within the tumor is administered. Once superficial tissue is excised, tumor tissue (faint gray) is illuminated with an excitation light source (with room lights on) resulting in NIR fluorescent emission. Next, cameras detect both the reflected room light (VIS) as well as the NIR fluorescent light while filtering out any reflected excitation light. (B) In some FGS implementations, the imaging and illumination modules are housed in a handheld module that the surgeon positions over the surgical cavity and a fusion of the visible and NIR detected images is presented on a separate display, allowing the surgeon to better visualize the tumor. An alternative is an AR implementation, where the fluorescent signal is false-colored and projected onto AR glasses in a position coaligned with the surgeon’s real world view of the tumor. (C) The core FGS technology as well as an AR implementation of FGS can be achieved with a wearable system made of accessible components. Excitation can be achieved with compact laser diodes. Dual white light and NIR imaging can be achieved with Raspberry Pi cameras coupled with off-the-shelf optical filters and mirrors and coaligned in a compact 3D printed assembly. Image acquisition and processing can be achieved with a battery-powered wearable Raspberry Pi computer, and AR display can be achieved with off-the-shelf AR glasses.