Application Effect of ICG Fluorescence Real-Time Imaging Technology in Laparoscopic Hepatectomy

Chen, Hao; Wang, Yumin; Xie, Zongqiang; Zhang, Luyuan; Yu, Jihai; Zhang, Chuanhai; Jia, Weidong; Ma, Jun; Liu, Wenbin

doi:10.3389/fonc.2022.819960

Cited by 13 publications

(12 citation statements)

References 44 publications

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“…1 . Conclusively, seven retrospective cohort articles encompassing 598 patients with 327 patients in the non-ICG group, and 271 patients in the ICG group were analyzed [ 25 – 31 ]. The number of tumors was 728 in total, comprising 364 tumors in the non-ICG group, and 364 tumors in the ICG group.…”

Section: Resultsmentioning

confidence: 99%

“…In total, seven studies [ 25 – 31 ] reported the R0 resection rate: 98.6% (359/364) in the ICG group and 93.1% (339/364) in the non-ICG group. Heterogeneity was not observed ( I 2 = 0%, P = 0.56).…”

Section: Resultsmentioning

confidence: 99%

“…In total, seven studies [ 25 – 31 ] reported the operative time. The mean operative time was 274.5 ± 111 min in the ICG group and 267.3 ± 109.1 min in the non-ICG group.…”

Section: Resultsmentioning

confidence: 99%

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Surgical margin status outcome of intraoperative indocyanine green fluorescence-guided laparoscopic hepatectomy in liver malignancy: a systematic review and meta-analysis

Tangsirapat,

Kengsakul,

Udomkarnjananun

et al. 2024

BMC Surg

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Background Hepatectomy stands as a curative management for liver cancer. The critical factor for minimizing recurrence rate and enhancing overall survival of liver malignancy is to attain a negative margin hepatic resection. Recently, Indocyanine green (ICG) fluorescence imaging has been proven implemental in aiding laparoscopic liver resection, enabling real-time tumor identification and precise liver segmentation. The purpose of this study is to conduct a systematic review and meta-analysis to ascertain whether ICG-guided laparoscopic hepatectomy yields a higher incidence of complete tumor eradication (R0) resections. Methods The search encompassed databases such as PubMed, Cochrane Library database, Scopus, ScienceDirect, and Ovid in April 2024, in strict adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies involving patients with malignant liver lesions who underwent ICG-guided laparoscopic hepatectomy and reported R0 resection outcomes were eligible for inclusion in this review. Results In a total of seven studies, involving 598 patients, were included in the meta-analysis. The ICG demonstrated a significantly elevated R0 resection rate compared to the non-ICG group [98.6% (359/364) vs. 93.1% (339/364), odds ratio (OR) = 3.76, 95% confidence intervals (CI) 1.45–9.51, P = 0.005]. Notably, no heterogeneity was observed (I2 = 0%, P = 0.5). However, the subtype analysis focusing on hepatocellular carcinoma [98.2% (165/168) vs. 93.6% (161/172), OR = 3.34, 95% CI 0.94–11.91, P = 0.06) and the evaluation of margin distance (4.96 ± 2.41 vs. 2.79 ± 1.92 millimeters, weighted mean difference = 1.26, 95% CI -1.8-4.32, P = 0.42) revealed no apparent differences. Additionally, the incidence of overall postoperative complications was comparable between both groups, 27.6% (66/239) in the ICG group and 25.4% (75/295) in the non-ICG group (OR = 0.96, 95% CI 0.53–1.76, P = 0.9). No disparities were identified in operative time, intraoperative blood loss, postoperative blood transfusion, and length of hospital stay after the surgery. Conclusions The implementation of ICG-guided laparoscopic hepatectomy can be undertaken with confidence, as it does not compromise either intraoperative or postoperative events. Furthermore, the ICG-guided approach is beneficial to achieving a complete eradication of the tumor during hepatic resection. Trial registration PROSPERO registration number CRD42023446440.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Surgical margin status outcome of intraoperative indocyanine green fluorescence-guided laparoscopic hepatectomy in liver malignancy: a systematic review and meta-analysis

Tangsirapat,

Kengsakul,

Udomkarnjananun

et al. 2024

BMC Surg

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“…11 studies ( 22 , 24 , 26 – 34 ) including 883 patients reported the intraoperative blood loss. there was highly heterogeneity between the two groups ( p < 0.0001, I 2 = 73%), and a random-effects model analysis was used.…”

Section: Resultsmentioning

confidence: 99%

Application of indocyanine green-mediated fluorescence molecular imaging technology in liver tumors resection: a systematic review and meta-analysis

Zhu¹,

Qiu²,

Zeng³

et al. 2023

Front. Oncol.

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BackgroundThis meta-analysis was dedicated to evaluating the safety and effectiveness of indocyanine green (ICG) -mediated fluorescence molecular imaging (FMI) technology in liver tumors resection.MethodsA literature search of PubMed, Embase databases, Cochrane Library, and Web of Science was performed to identify all clinical controlled studies exploring the effects of fluorescence imaging on liver tumors resection. Quality assessment and data extraction of studies were conducted independently by 3 reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software.Results14 retrospective cohort studies (RCSs) involving a total of 1227 patients were finally included. The results showed that Fluorescence-assisted liver tumors resection could improve the R0 resection rate (OR = 2.63; 95% CI: 1.46~4.73, p = 0.001), reduce overall complications (OR = 0.66; 95% CI: 0.44~0.97, p = 0.04), biliary fistula (OR = 0.20; 95% CI: 0.05~0.77, p = 0.02), intraoperative blood loss (MD = −70.76, 95% CI: −106.11 to −35.41; p < 0.0001), and shortens hospital stay (MD = −1.41, 95% CI: −1.90 to −0.92; p < 0.00001). There were no significant differences in the incidences of operative time (MD = −8.68, 95% CI: −18.59 to −1.22; p = 0.09), complications of grade III or above (OR = 0.73; 95% CI: 0.43~1.25, p = 0.26), liver failure (OR = 0.86; 95% CI: 0.39~1.89, p = 0.71), and blood transfusion (OR = 0.66; 95% CI: 0.42~1.03, p = 0.07).ConclusionCurrent evidence suggests that ICG-mediated FMI technology could enhance the clinical effectiveness of patients with liver tumors resection and is clinically worthy of promotion.Systematic review registrationPROSPERO, identifier CRD42022368387.

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“…Moreover, CLI involves some controversial issues of radiation protection and occupation exposure, which limits the popularity of its clinical practice. In contrast, near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG), a fluorescent contrast dye approved by Food and Administration (FDA), has been greatly broadened from ophthalmology ( 11 ), liver surgery ( 12 – 14 ), sentinel lymph nodes biopsy ( 15 ), and flap transfer ( 16 ) to intraoperative navigation in all sorts of tumor resections. In 2009, Kokudo et al ( 17 ) happened to discover that hepatocellular carcinoma fluoresced strongly when these patients received a routine liver function test by intravenous injection of ICG prior to the surgery, which resulted in a clinical trial to investigate this novel fluorescent imaging techniques.…”

Section: Introductionmentioning

confidence: 99%

Modified low-dose second window indocyanine green technique improves near-infrared fluorescence image-guided dermatofibrosarcoma protuberans resection: A randomized control trial

Cui

Wang²,

Li³

et al. 2022

Front. Surg.

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ObjectiveConventional second window indocyanine green (SWIG) technique has been widely attempted in near-infrared fluorescence (NIRF) imaging for intraoperative navigation of tumor radical resection. Nevertheless, the overuse of indocyanine green (ICG) led to an increased risk of drug lethal allergy and high medical cost. This prospective study was to explore clinical application of modified low-dose SWIG technique in guiding dermatofibrosarcoma protuberans (DFSPs) radical resection.MethodPatients with DFSPs were randomly assigned to control and experimental group. The ICG was injected intravenously 24 h before surgery, at a dose of 3.5 mg/kg in the control group and 25 mg/patient in the experiment group, respectively. Intraoperative NIRF imaging included serial views of gross tumor, tumor bed and cross-sectional specimen.ResultsAlthough NIRF imaging of gross tumor and tumor bed in the experimental group demonstrated similar sensitivity and negative predictive value, the specificity and positive predictive value were obviously higher compared to control group. The tumor-to-background ratios of cross-sectional specimens in the experimental group was significantly higher than in the control group (P = 0.000). Data in both groups displayed that there was a positive correlation of tumor size in cross-sections between integrated histopathologic photomicrographs and NIRF imaging of specimen views (P = 0.000). NIRF imaging of cross-sectional specimens had a significant decrease in time cost, and an increase in the ability of examining more surgical margins (P = 0.000).ConclusionThis is the first study to demonstrate that a low-dose SWIG technique could improve the accuracy of near-infrared fluorescence image-guided dermatofibrosarcoma protuberans resection.Clinical Trial Registration: ChiCTR2100050174; date of registration: August 18, 2021 followed by “retrospectively registered”

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Application Effect of ICG Fluorescence Real-Time Imaging Technology in Laparoscopic Hepatectomy

Cited by 13 publications

References 44 publications

Surgical margin status outcome of intraoperative indocyanine green fluorescence-guided laparoscopic hepatectomy in liver malignancy: a systematic review and meta-analysis

Surgical margin status outcome of intraoperative indocyanine green fluorescence-guided laparoscopic hepatectomy in liver malignancy: a systematic review and meta-analysis

Application of indocyanine green-mediated fluorescence molecular imaging technology in liver tumors resection: a systematic review and meta-analysis

Modified low-dose second window indocyanine green technique improves near-infrared fluorescence image-guided dermatofibrosarcoma protuberans resection: A randomized control trial

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