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Abstract

System and method for detection and localization of malignant tissue in situ during a medical procedure such as endoscopy or surgery. A fluorescent metabolic imaging agent, consisting of a carbohydrate analog coupled to a fluorophore in a manner such that the imaging agent accumulates in tissue in proportion to the glucose metabolic rate of the tissue, is systemically or locally injected into a patient before commencement of the endoscopic or surgical procedure. After a period of time during which the imaging agent accumulates in the body tissue, the tissue under examination in the endoscopic or surgical field of view is illuminated by a broadband light source filtered by an optical bandpass excitation filter to transmit light at the fluorescent excitation wavelength of the imaging agent. An optical bandpass emission filter filters the light emitted from the illuminated tissue to transmit light at the fluorescent emission wavelength of the imaging agent to a high-sensitivity cooled-CCD video camera. The CCD video camera acquires an image of the tissue, and a camera controller digitizes the analog video output signal of the camera and transfers the digitized data to a computer. The computer software reformats the data into a video frame, performs image processing algorithms on the video frame, and displays the frame on a video monitor as a color-coded image. Different colors in the color scale represent varying levels of glucose metabolism in different areas of the tissue under examination, and areas of malignant tissue are detectable by their characteristic hypermetabolism.

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