Apparatus and methods for fluorescence guided surgery

An imaging apparatus for determining a distribution of fluorescence emission sources in a patient in an operating room, the apparatus comprising:

• a support member comprising an outer solid portion and a hollow interior portion;
• a plurality of optical fibers, wherein the excitation light that extend through the outer solid portion of the support member;
• one or more excitation light sources configured to provide excitation light at a surgery site of the patient by directing the excitation light through the plurality of optical fibers;
• a structured light source configured to generate structured illumination light;
• a photographic imager for obtaining one or more images of the surgery site;
• a fluorescence imager for detecting fluorescent emission from the surgery site in response to the excitation light;
• and
• a controller configured to:
• activate the structured light source to illuminate the surgery site through the hollow portion of the support member with structured illumination light, and to obtain an image of the structured illumination light on the surgery site using the photographic imager;
• activate the one or more excitation light sources to sequentially direct the excitation light through each one of the plurality of optical fibers in turn to illuminate a different position at the surgery site, and to obtain a plurality of images of fluorescence emission from the surgery site using the fluorescence imager, wherein each one of the plurality of fluorescence emission images corresponds to illumination through a different one of the optical fibers;
• determine a three-dimensional surface representation of at least a portion of the surgery site based on the image of the structured illumination on the surgery site;
• determine a distribution of fluorescence emission in a boundary region inside a surface of the surgery site based on the plurality of images of fluorescence emission and the three-dimensional surface representation;
• and
• determine a distribution of fluorescence emission sources internal to the surgery site based on the distribution of fluorescence emission in the boundary region by performing a tomographic reconstruction based on a photon diffusion model.