Clinical implications of Indocyanine Green Fluorescence Imaging-Guided laparoscopic lymphadenectomy for patients with gastric cancer: A cohort study from two randomized, controlled trials using individual patient data

Zhong, Qing; Chen, Qi‐Yue; Xiao-bo, Huang; Lin, Guang-Tan; Liu, Zhiyu; Chen, Junyu; Wang, Hua-Gen; Weng, Kai; Li, Ping; Xie, Jian‐Wei; Ji, Lin; Lü, Jun; Ma, Lin; Huang, Ze-Ning; Zheng, Chao‐Hui; Huang, Chang‐Ming

doi:10.1016/j.ijsu.2021.106120

Cited by 36 publications

(33 citation statements)

References 40 publications

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“…Furthermore, both the FUGES-012 and FUGES-019 trials collected data from patients who did not undergo neoadjuvant treatment, and different outcomes could be expected from procedures after neoadjuvant treatment due to different node drainage patterns. Therefore, long-term oncological outcomes are still anticipated ( 60 ).…”

Section: Lymph Nodesmentioning

confidence: 99%

The Use of Indocyanine Green (ICG) and Near-Infrared (NIR) Fluorescence-Guided Imaging in Gastric Cancer Surgery: A Narrative Review

Belia

Biondi²,

Santocchi³

et al. 2022

Front. Surg.

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Near-infrared fluorescence imaging with indocyanine green is an emerging technology gaining clinical relevance in the field of oncosurgery. In recent decades, it has also been applied in gastric cancer surgery, spreading among surgeons thanks to the diffusion of minimally invasive approaches and the related development of new optic tools. Its most relevant uses in gastric cancer surgery are sentinel node navigation surgery, lymph node mapping during lymphadenectomy, assessment of vascular anatomy, and assessment of anastomotic perfusion. There is still debate regarding the most effective application, but with relatively no collateral effects and without compromising the operative time, indocyanine green fluorescence imaging carved out a role for itself in gastric resections. This review aims to summarize the current indications and evidence for the use of this tool, including the relevant practical details such as dosages and times of administration.

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Section: Lymph Nodesmentioning

confidence: 99%

The Use of Indocyanine Green (ICG) and Near-Infrared (NIR) Fluorescence-Guided Imaging in Gastric Cancer Surgery: A Narrative Review

Belia

Biondi²,

Santocchi³

et al. 2022

Front. Surg.

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“…ICG FMI–guided D2 lymphadenectomy should be performed routinely for the patients with advanced gastric cancer. To evaluate the feasibility of imaging metastatic lymph nodes using ICG, Zhong et al performed a 514 patients enrolled study [ 76 ]. The ICG FMI had a sensitivity of 86.8% to the metastatic lymph nodes, while the negative predictive value was 92.2% to the non-fluorescent nodes.…”

Section: Lymphatic Fmi Imagingmentioning

confidence: 99%

Intraoperative fluorescence molecular imaging accelerates the coming of precision surgery in China

Zhang

Chi

et al. 2022

Eur J Nucl Med Mol Imaging

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Purpose China has the largest cancer population globally. Surgery is the main choice for most solid cancer patients. Intraoperative fluorescence molecular imaging (FMI) has shown its great potential in assisting surgeons in achieving precise resection. We summarized the typical applications of intraoperative FMI and several new trends to promote the development of precision surgery. Methods The academic database and NIH clinical trial platform were systematically evaluated. We focused on the clinical application of intraoperative FMI in China. Special emphasis was placed on a series of typical studies with new technologies or high-level evidence. The emerging strategy of combining FMI with other modalities was also discussed. Results The clinical applications of clinically approved indocyanine green (ICG), methylene blue (MB), or fluorescein are on the rise in different surgical departments. Intraoperative FMI has achieved precise lesion detection, sentinel lymph node mapping, and lymphangiography for many cancers. Nerve imaging is also exploring to reduce iatrogenic injuries. Through different administration routes, these fluorescent imaging agents provided encouraging results in surgical navigation. Meanwhile, designing new cancer-specific fluorescent tracers is expected to be a promising trend to further improve the surgical outcome. Conclusions Intraoperative FMI is in a rapid development in China. In-depth understanding of cancer-related molecular mechanisms is necessary to achieve precision surgery. Molecular-targeted fluorescent agents and multi-modal imaging techniques might play crucial roles in the era of precision surgery.

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“…Therefore, it is necessary to carefully compare the ICG-FI group vs. non-ICG-FI group. It should also be considered that recent studies observed a decline in sensitivity for detecting all metastatic stations in advanced tumor stages [ 13 , 14 ]. Park et al, examined the applicability of ICG-FI in the mapping of perigastric lymphatic networks in cases of advanced gastric cancer, documenting the topography and ICG-staining of each lymph node and lymph node station and comparing it with corresponding pathological findings.…”

Section: Lymph Node Mapping With Icg-fi In Gastric Carcinomamentioning

confidence: 99%

New Intraoperative Imaging Tools and Image-Guided Surgery in Gastric Cancer Surgery

et al. 2022

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Innovations and new advancements in intraoperative real-time imaging have gained significant importance in the field of gastric cancer surgery in the recent past. Currently, the most promising procedures include indocyanine green fluorescence imaging (ICG-FI) and hyperspectral imaging or multispectral imaging (HSI, MSI). ICG-FI is utilized in a broad range of clinical applications, e.g., assessment of perfusion or lymphatic drainage, and additional implementations are currently investigated. HSI is still in the experimental phase and its value and clinical relevance require further evaluation, but initial studies have shown a successful application in perfusion assessment, and prospects concerning non-invasive tissue and tumor classification are promising. The application of machine learning and artificial intelligence technologies might enable an automatic evaluation of the acquired image data in the future. Both methods facilitate the accurate visualization of tissue characteristics that are initially indistinguishable for the human eye. By aiding surgeons in optimizing the surgical procedure, image-guided surgery can contribute to the oncologic safety and reduction of complications in gastric cancer surgery and recent advances hold promise for the application of HSI in intraoperative tissue diagnostics.

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Clinical implications of Indocyanine Green Fluorescence Imaging-Guided laparoscopic lymphadenectomy for patients with gastric cancer: A cohort study from two randomized, controlled trials using individual patient data

Cited by 36 publications

References 40 publications

The Use of Indocyanine Green (ICG) and Near-Infrared (NIR) Fluorescence-Guided Imaging in Gastric Cancer Surgery: A Narrative Review

The Use of Indocyanine Green (ICG) and Near-Infrared (NIR) Fluorescence-Guided Imaging in Gastric Cancer Surgery: A Narrative Review

Intraoperative fluorescence molecular imaging accelerates the coming of precision surgery in China

New Intraoperative Imaging Tools and Image-Guided Surgery in Gastric Cancer Surgery

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