# Optical and electromagnetic tracking guidance for hepatic interventions

> **NIH NIH U01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $83,049

## Abstract

Abstract
Percutaneous sampling of focal hepatic lesions is a cornerstone in the management of patients with hepatic
pathology. The advent of advanced imaging has improved the sensitivity for lesion detection; however small
lesions often lack specific features to allow for reliable non-invasive characterization, resulting in an increase in
the number of biopsies for such hepatic lesions over the past decade. Accuracy of a focal hepatic biopsy is
essential, as a false negative biopsy can have a devastating impact on a patient's treatment. In a retrospective
study, up to 45% of small hepatic lesions were insufficiently visualized with the biopsy needle in place and had
a false negative rate, defined as the number of patients with benign biopsies who were subsequently found to
have malignant lesions at the attempted site of biopsy, of 37% for hepatocellular carcinomas. Thus, there is a
significant need for improved methods for accurately sampling hepatic lesions. Recently, it was discovered that
indocyanine green (ICG), a clinically approved near infrared fluorochrome, accumulates in hepatic foci such as
hepatocellular carcinomas and hepatic colorectal metastases, resulting in a high target to background ratio
when visualized using near infrared light. The PI of this proposal has led the first human experience, at MGH,
combining optical imaging using ICG with interventional radiology percutaneous hepatic sampling.
Independently, the intramural PI of this proposal has pioneered the development and clinical trials of
electromagnetic (EM) navigation techniques for interventional radiology guided percutaneous sampling at the
NIH Clinical Center – Center for Interventional Oncology (CIO). We propose to build upon a longstanding
collaboration between the extramural and intramural PIs, and combine these two intrinsically synergistic,
recent advances in the field of interventional radiology. The EM guided devices navigate the biopsy needle
close to imaged lesions and can be thought of as far-field optimized; the optical imaging devices provide real-
time feedback to assess if needle cores are appropriately located within small hepatic tumors and can be
thought of as near-field devices. This first-in-man assessment of the new, proposed intramural-extramural
jointly developed device will take place at the NIH CC-CIO. This jointly created and iteratively optimized device
will help to improve patient care through improved diagnostic accuracy.

## Key facts

- **NIH application ID:** 9973087
- **Project number:** 5U01CA202934-04
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Umar Mahmood
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $83,049
- **Award type:** 5
- **Project period:** 2017-03-02 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9973087

## Citation

> US National Institutes of Health, RePORTER application 9973087, Optical and electromagnetic tracking guidance for hepatic interventions (5U01CA202934-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9973087. Licensed CC0.

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