Fiber Optic RealShape (FORS) technology

Technology explained

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.

Features

Device visualization

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.

Viewing clarity

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 the catheter

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. 

Customery story video

Customer story

Relying on Fiber Optic rather than X- ray  

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 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 

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

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

Clinical: Superficial Femoral Artery Recanalization Using Fiber Optic RealShape Technology

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

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

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

Clinical: First in Human Clinical Feasibility Study of Endovascular Navigation with Fiber Optic RealShape (FORS) Technology

Van Herwaarden (UMCU), […], Hazenberg (UMCU)

EJVES

Nov 2020

Clinical: Fiber Optic RealShape technology in endovascular surgery

Finnesgard (UMASS), […], Schanzer (UMASS)

Seminars in Vascular Surgery

Oct 2021

Clinical: Fiber Optic RealShape (FORS) Technology for Endovascular Navigation in Severe Tortuous Vessels

Panuccio (UKE), […], Kölbel (UKE)

Journal of Endovascular Therapy

Jan 2022

Clinical: Fiber Optic RealShape Guidance in Endovascular Aortic Repair

Finnesgard (UMASS), [..], Schanzer (UMASS)

Endovascular Today

Mar 2022

Clinical: Superficial Femoral Artery Recanalization Using Fiber Optic RealShape Technology

Klaassen (UMCU), […], Hazenberg (UMCU)

Medicina

Jul 2022

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

Guidelines: Mention of FORS in the ESVS Radiation Safety Guidelines

Modarai et al (GSST)

ESVS

Sept 2022

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

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

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

Clinical: Radiation Dose Reduction During Contralateral Limb Cannulation Using Fiber Optic RealShape Technology in Endovascular Aneurysm Repair

Klaassen (UMCU),(….), Heerwaarden (UMCU)

EJVS

Nov 2023

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

Clinical: Initial Single Center Experience Using Fiber Optic RealShape Guidance in Complex Endovascular Aortic Repair (follow-up to NESVS abstract) 

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

We are always interested in engaging with you.

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Footnotes
 

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

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