Fiber Optic RealShape (FORS) technology

Using light instead of X- ray

Fiber Optic RealShape (FORS) technology sparks a new era in device guidance. Using the wonders of light, this unique innovation, exclusive to Philips, enables real-time, 3D visualization of devices* inside the body. Without the need for fluoro!

FORS- enabled guidewires have a hair-thin optical fiber integrated into them. By pulsing light into the fiber and analyzing how it is reflected, the full shape of devices can be reconstructed and visualized. These devices are shown in the context of the patient’s anatomy through overlay on images that are acquired before or during the procedure, like CT scans and X- rays.

Discover Philips LumiGuide,
powered by FORS technology

Work confidently and safely in an increasingly radiation-free lab. With LumiGuide, you see more, perform fast, stay safe – and push the boundaries of care for your patients.

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Features

Device visualization using the wonders of light

With FORS technology, clinicians can carry out parts of minimally-invasive interventions without the need for X- ray, which should minimize the risks associated with long-term radiation exposure.

Unprecedented viewing clarity

FORS technology makes it possible to display the full shape of devices in 3D and in distinctive colors, as opposed to the 2D, greyscale visualization produced by fluoroscopy. FORS images are generated in real-time, and can be rotated and tilted to allow viewing from any angle.

Visualize your catheter of choice

Thanks to 3D Hub technology, you can continue to work with the catheters you’re already used to. The 3D Hub, in combination with FORS-enabled guidewires, enables your catheters to be visualized inside the body.

From outer space to inner space

FORS technology is exclusive to Philips and is the result of our expertise, built up over many decades, in optics, devices and image guidance. Certain technologies we used originally came from NASA. We adapted, miniaturized and made them accurate enough for specific healthcare applications, then integrated them into a solution. In other words: we take innovations from outer space and further develop them for inner space.

Customer story

Relying on Fiber Optic rather than X- ray

A professor of vascular surgery talks about the benefits of carrying out minimally- invasive endovascular aortic repair using visualization that doesn’t require X- ray.

Bijan Modarai, Professor of Vascular Surgery at Guy's and St. Thomas' NHS Foundation Trust and King's College, London.

Frequently asked questions

How does Fiber Optic RealShape technology work?: A four-core optical fiber is integrated into a guidewire. By sending light into this fiber and then analyzing how the light is reflected back along the length of the fiber, it becomes possible to calculate the shape as well as the perspective. In fact, you can ‘see’ the whole fiber, and thereby the guidewire (and a catheter slid over it). In real time. There is no need for additional external imaging technology; the device literally visualizes itself.
Is X-ray still necessary when conducting a FORS-enabled procedure?: X-ray is still necessary to visualize the patient anatomy. FORS technology only visualizes devices. However, FORS has already been shown to reduce radiation exposure, for the patient and staff, during complex aortic procedures.
What is the level of accuracy?: FORS is already accurate enough for top-level vascular surgeons to use LumiGuide (powered by FORS technology) in real-life interventions. For more details on accuracy, see:

Three-Dimensional Visualization of Endovascular Guidewires and Catheters Based on Laser Light instead of Fluoroscopy with Fiber Optic RealShape Technology

Jansen, van Herwaarden et al. European Journal of Vascular & Endovascular Surgery.

DOI: doi.org/10.1016/j.ejvs.2020.02.035

"FORS based device visualization [is] superior to conventional fluoroscopic imaging, while not affecting the mechanical properties (torquability, pushability) of the FORS-enabled guidewire and catheters."

Shape accuracy of fiber optic sensing for medical devices characterized in bench experiments

Megens, 't Hooft et al. Technical paper in Medical Physics for fluoroscopy.

DOI: doi.org/10.1002/mp.14881

"The technology achieves submillimeter precision and provides full three-dimensional shape, surpassing the reported precision of other navigation and tracking technologies."

3D Visualization of Navigation Catheters for Endovascular Procedures Using a 3D Hub and Fiber Optic RealShape

Bydlon, Flexman et al. RealShape Technology: Phantom Study Results

DOI: doi.org/10.1016/j.ejvsvf.2023.05.006

"Visualization of navigation catheters is highly accurate with the 3D Hub technology."
Can I continue to use the catheters I’m familiar with?: Yes. FORS has been specifically designed to work with standard catheters, in combination with the Philips 3D Hub. The Fiber Optic RealShape technology is integrated into the guidewire that the catheter slides over, and not the catheter itself.

Building the continuum of evidence

Podium presentations

Pre-clinical study results by Prof. Joost van Herwaarden at Aortic Live symposium 2018

FIH study results by Prof. Joost van Herwaarden at LINC 2020

Fiber Optic RealShape technology in practice by Prof. Tilo Kölbel at LINC 2020

Expanding clinical experience using Fiber Optic technology in complex aortic repair by Prof. Tilo Kölbel at CX 2020

3D catheter agnostic guidance by Prof. Marc Schermerhorn at CX 2021

FORS Technology: Branched Clinical Usage, Learnings And Future Perspectives by Prof Tilo Kölbel at LINC 2022

Latest Clinical cases using FORS technology and Data published to-date by Tilo Kölbel at LINC 2023

Updated Experience with Fiber Optic RealShape – technology (FORS): Advantages and Limitations by Joost van Herwaarden at VEITH 2023

Case videos

Edited case shared by Prof. Joost van Herwaarden at CX 2019

Edited case (FEVAR) shared by Prof. Tilo Kölbel at both Aortic Live 2020 and LINC 2021

Edited case (BEVAR) shared by Prof. Tilo Kölbel at CX Aortic 2021

Publications

Topic / Title	Authors (Institution)	Journal	Date (Published)	Link
Technical: Shape accuracy of fiber optic sensing for medical devices characterized in bench experiments	Megens (Philips), […], ‘t Hooft (Philips)	Medical Physics	Apr 2021	doi.org/10.1002/mp.14881
Technical: 3D Visualisation of Navigation Catheters for Endovascular Procedures Using a 3D Hub and Fiber Optic RealShape Technology: Phantom Study Results	Torre M. Bydlon (Philips), Molly L. Flexman (Philips)	EJVES – Vascular forum	May 2023 Online ahead of print	doi.org/10.1016/j.ejvsvf.2023.05.006
Pre-Clinical: Three Dimensional Visualization of Endovascular Guidewires and Catheters Based on Laser Light instead of Fluoroscopy with Fiber Optic RealShape Technology: Preclinical Results	Jansen (UMCU), […], Van Herwaarden (UMCU)	EJVES	Jul 2020	doi.org/10.1016/j.ejvs.2020.02.035
Clinical: First in Human Clinical Feasibility Study of Endovascular Navigation with Fiber Optic RealShape (FORS) Technology	Van Herwaarden (UMCU), […], Hazenberg (UMCU)	EJVES	Nov 2020	doi.org/10.1016/j.ejvs.2020.10.016
Clinical: Fiber Optic RealShape technology in endovascular surgery	Finnesgard (UMASS), […], Schanzer (UMASS)	Seminars in Vascular Surgery	Oct 2021	doi.org/10.1053/j.semvascsurg.2021.10.001
Clinical: Fiber Optic RealShape (FORS) Technology for Endovascular Navigation in Severe Tortuous Vessels	Panuccio (UKE), […], Kölbel (UKE)	Journal of Endovascular Therapy	Jan 2022	doi.org/10.1177/15266028211070969
Clinical: Fiber Optic RealShape Guidance in Endovascular Aortic Repair	Finnesgard (UMASS), [..], Schanzer (UMASS)	Endovascular Today	Mar 2022	Fiber Optic RealShape Guidance in Endovascular Aortic Repair (evtoday.com)
Clinical: Superficial Femoral Artery Recanalization Using Fiber Optic RealShape Technology	Klaassen (UMCU), […], Hazenberg (UMCU)	Medicina	Jul 2022	doi.org/10.3390/medicina58070961
Clinical: Endovascular Navigation with Fiber Optic RealShape (FORS) Technology: prospective analysis of the first 50 patients at UHZ	Panuccio (UKE), […] Kölbel (UKE)	JVS	Aug 2022	doi.org/10.1016/j.jvs.2022.08.002
Guidelines: Mention of FORS in the ESVS Radiation Safety Guidelines	Modarai et al (GSST)	ESVS	Sept 2022	doi.org/10.1016/j.ejvs.2022.09.005
Clinical: Initial Single Center Experience Using Fiber Optic RealShape Guidance in Complex Endovascular Aortic Repair (follow-up to NESVS abstract)	Finnesgard (UMASS), […], Schanzer (UMASS)	JVS	Nov 2022	doi.org/10.1016/j.jvs.2022.11.041
Clinical: Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound	Hazenberg (UMCU), […], Van Herwaarden (UMCU)	JOVE	Apr 2023	dx.doi.org/10.3791/64956-v
Clinical: Fiber Optic RealShape (FORS) imaging using upper extremity and transfemoral access for Fenestrated-Branched Endovascular Aortic Aneurysm Repair (FBEVAR)	Pavarino (UTSW), […], Timaran (UTSW)	JVS-CIT	Apr 2023 Online ahead of print	doi.org/10.1016/j.jvscit.2023.101191
Clinical: Radiation Dose Reduction During Contralateral Limb Cannulation Using Fiber Optic RealShape Technology in Endovascular Aneurysm Repair	Klaassen (UMCU), (….), Heerwaarden (UMCU)	EJVS	Nov 2023	https://doi.org/10.1016/j.ejvs.2023.10.041
Clinical: The effect of Fiber Optic RealShape technology on the reduction of radiation during complex endovascular surgery	Sanders (BIDMC), (….), Schermerhorn (BIDMC) (BIDMC)	JVS	Nov 2023	https://doi.org/10.1016/j.jvs.2023.11.002

Symposium and interviews

B-Learning interview between Prof. Joost van Herwaarden and Prof. Tilo Kölbel, done at VEITH 2019

Meet the Expert session as recorded during CX21. Discussion panel with Limited Editions sites

B-Learning interview between Prof. Tilo Kölbel, Prof. Joost van Herwaarden, and Prof. Geert Willem Schurink, May 2021

Panel discussion with Limited Edition during CX Aortic 2021

Symposium by Prof. GW Schurink at LINC 2022

Footnotes

[1] *The FORS-enabled guidewire as well as compatible endovascular catheters.