
Background
Near-infrared (NIR) fluorescence imaging has emerged as a transformative technique in veterinary oncology, enhancing surgical precision through real-time, high- resolution visualization of anatomical and pathological structures. NIR-guided surgery utilizes fluorescent dyes, such as indocyanine green (ICG), which emit light in the near-infrared spectrum (700–900 nm) upon excitation. This wavelength range allows for deeper tissue penetration and minimal background interference, making it particularly suited for intraoperative guidance.
NIRF-L
Accurate staging and removal of regional lymph nodes are crucial in managing many veterinary cancers, including mast cell tumors, melanoma, mammary carcinoma, medullary thyroid carcinoma and anal sac adenocarcinoma. However, lymph node localization, especially in small or obese animals, can be challenging with traditional methods. NIR-guided lymphadenectomy addresses this by enabling the visualization of lymphatic drainage pathways and sentinel lymph nodes (SLNs) following peritumoral or subcutaneous injection of ICG. Surgeons can observe lymph flow in real time, identify SLNs with high accuracy, and resect them with minimal surrounding tissue disruption. This significantly improves resection success, speeds the procedure and reduces the morbidity by facilitating smaller approachs.
Angiography for Flap Perfusion Studies
In reconstructive oncologic surgery, ensuring adequate perfusion of skin flaps is essential for healing and minimizing complications. NIR angiography allows for the intraoperative assessment of flap vascularization by intravenous injection of ICG. Within seconds, the dye highlights perfused vasculature, allowing surgeons to assess flap viability, revise poorly perfused regions, and predict postoperative outcomes. This technique reduces flap necrosis risk and promotes more confident surgical decision- making in complex reconstructions.
Tumor Imaging
NIR imaging also facilitates tumor margin visualization, especially when tumors are poorly demarcated from surrounding tissue. Passive accumulation of ICG in tumor tissue, or the use of targeted NIR probes binding to tumor-specific markers, can help delineate tumor boundaries intraoperatively. This enables more complete resections while sparing healthy tissue, reducing recurrence risks and improving functional outcomes.
In conclusion, NIR-guided surgery in veterinary oncology significantly enhances surgical accuracy and outcomes across multiple applications. Its integration into lymphadenectomy, flap viability assessment, and tumor imaging exemplifies a growing trend toward precision and minimally invasive approaches in veterinary surgical oncology.