Multimodal soft tissue markers for bridging high-resolution diagnostic imaging with therapeutic intervention

Anders E. Hansen, Jonas R. Henriksen, Rasmus I. Jølck, Frederikke P. Fliedner, Linda M. Bruun, Jonas Scherman, Andreas I. Jensen, Per Munck Af Rosenschöld, Lilah Moorman, Sorel Kurbegovic, Steen R. de Blanck, Klaus R. Larsen, Paul F. Clementsen, Anders N. Christensen, Mads Hartvig Clausen, Wenbo Wang, Paul Kempen, Merete Christensen, Niels Erik Viby, Gitte PerssonRasmus Larsen, Knut Conradsen, Fintan J. McEvoy, Andreas Kjaer, Thomas Eriksen, Thomas L. Andresen

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Diagnostic imaging often outperforms the surgeon's ability to identify small structures during therapeutic procedures. Smart soft tissue markers that translate the sensitivity of diagnostic imaging into optimal therapeutic intervention are therefore highly warranted. This paper presents a unique adaptable liquid soft tissue marker system based on functionalized carbohydrates (Carbo-gel). The liquid state of these markers allows for high-precision placement under image guidance using thin needles. Based on step-by-step modifications, the image features and mechanical properties of markers can be optimized to bridge diagnostic imaging and specific therapeutic interventions. The performance of Carbo-gel is demonstrated for markers that (i) have radiographic, magnetic resonance, and ultrasound visibility; (ii) are palpable and visible; and (iii) are localizable by near-infrared fluorescence and radio guidance. The study demonstrates encouraging proof of concept for the liquid marker system as a well-tolerated multimodal imaging marker that can improve image-guided radiotherapy and surgical interventions, including robotic surgery.

Original languageEnglish
Article numbereabb5353
JournalScience Advances
Issue number34
Number of pages12
Publication statusPublished - 1 Aug 2020

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