{"doi":"10.3390/cancers17162676","title":"Clinical Integration of NIR-II Fluorescence Imaging for Cancer Surgery: A Translational Evaluation of Preclinical and Intraoperative Systems","abstract":"Background/Objectives: Back table fluorescence imaging performed on freshly excised tissue specimens represents a critical step in fluorescence-guided surgery, enabling rapid assessment of tumor margins before final pathology. While most preclinical NIR-II imaging platforms, such as the IR VIVO (Photon, etc.), offer high-resolution and depth-sensitive imaging under controlled, enclosed conditions, they are not designed for intraoperative or point-of-care use. This study compares the IR VIVO with the LightIR system, a more compact and clinically adaptable imaging platform using the same Alizé 1.7 InGaAs detector, to evaluate whether the LightIR can offer comparable performance for back table NIR-II imaging under ambient light. Methods: Standardized QUEL phantoms containing indocyanine green (ICG) and custom agar-based tissue-mimicking phantoms loaded with IR-1048 were imaged on both systems. Imaging sensitivity, spatial resolution, and depth penetration were quantitatively assessed. LightIR was operated in pulse-mode under ambient lighting, mimicking back table or intraoperative use, while IR VIVO was operated in a fully enclosed configuration. Results: The IR VIVO system achieved high spatial resolution (~125 µm) and detected ICG concentrations as low as 30 nM in NIR-I and 300 nM in NIR-II. The LightIR system, though requiring longer exposure times, successfully resolved features down to ~250 µm and detected ICG to depths ≥4 mm. Importantly, the LightIR maintained robust NIR-II contrast under ambient lighting, aided by real-time background subtraction, and enabled clear visualization of subsurface IR-1048 targets in unshielded phantom setups, conditions relevant to back table workflows. Conclusions: LightIR offers performance comparable to the IR VIVO in terms of depth penetration and spatial resolution, while also enabling open-field NIR-II imaging without the need for a blackout enclosure. These features position the LightIR as a practical alternative for rapid, high-contrast fluorescence assessment during back table imaging. The availability of such clinical-grade systems may catalyze the development of new NIR-II fluorophores tailored for real-time surgical applications.","journal":"Cancers","year":2025,"id":518669,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9599,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":353800,"name":"Justin Williams","orcid":"0000-0002-0195-5509","position":1,"is_corresponding":false},{"id":1386571,"name":"David Rioux","orcid":null,"position":2,"is_corresponding":false},{"id":1386572,"name":"Paul Dorval","orcid":null,"position":3,"is_corresponding":false},{"id":23578,"name":"Wendy K. Chung","orcid":"0000-0003-3438-5685","position":4,"is_corresponding":false},{"id":1386573,"name":"Pierre-Alix Dancer","orcid":null,"position":5,"is_corresponding":false},{"id":362111,"name":"Edward J. Delikatny","orcid":"0000-0001-5234-3724","position":6,"is_corresponding":false},{"id":1267740,"name":"Ritesh K. Isuri","orcid":"0009-0004-1710-6562","position":0,"is_corresponding":true}],"reference_count":58,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:49:09.679930Z","pmid":"40867305","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}