Image‐Guided Liver Mapping Using Fluorescence Navigation System with Indocyanine Green for Anatomical Hepatic Resection

Aoki, Takeshi; Yasuda, Daisuke; Shimizu, Yoshinori; Odaira, Masanori; Niiya, Takashi; Kusano, Tomokazu; Mitamura, Keiji; Hayashi, Ken; Murai, Noriyuki; Koizumi, Toru; Kato, Hirohisa; Enami, Yuta; Miwa, Makoto; Kusano, Mitsuo

doi:10.1007/s00268-008-9620-y

Cited by 254 publications

(189 citation statements)

References 21 publications

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“…15,16,21 Intravenously injected ICG binds to serum proteins and fluoresces in near-infrared light. The protein-bound ICG is excreted into the bile juice through hepatocytes.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14] Recently, a highly sensitive fluorescent imaging technique using a near-infrared camera system has been developed and has made it possible to identify small hepatic tumors during surgery. 15, 16 We applied this technique to pancreatic cancer treatment to detect hepatic micrometastases, which may not be detected by conventional preoperative or intraoperative diagnostic modalities; herein, we report the preliminary results of our procedure.…”

Section: Introductionmentioning

confidence: 99%

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Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Yokoyama

Otani

Hashidate

et al. 2011

Cancer

106

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BACKGROUND: Recently, a highly sensitive fluorescent imaging technique was developed for the real-time identification of hepatic tumors. The authors applied this procedure for the intraoperative detection of radiographically occult hepatic micrometastases from pancreatic cancer. METHODS: Forty-nine consecutive patients with pancreatic cancer who underwent surgical intervention were examined. Preoperative clinical images had not revealed any hepatic metastases. On the day before surgery, indocyanine green was injected intravenously. During the operation, the liver was observed with a near-infrared camera system, and abnormal fluorescent foci were examined by frozen-section histology. The patients with hepatic micrometastases were judged to have unresectable disease and underwent only palliative surgery followed by systemic chemotherapy using gemcitabine. RESULTS: Abnormal hepatic fluorescence at least 1.5 mm in greatest dimension without any apparent tumor was observed in 13 patients. Among them, histologic examination confirmed micrometastases in 8 of 49 patients (16%). All patients with hepatic micrometastases had clinical T3 or T4 disease and high serum CA19-9 levels (P ¼ .042). On follow-up computed tomography images that were obtained within 6 months after surgery, the patients with hepatic micrometastases manifested hepatic overt metastases (7 of 8 patients; 88%) more frequently than the patients without hepatic micrometastases (4 of 41 patients; 10%; P < .001). Regardless of histologic confirmation, the positive predictive value of abnormal fluorescence for the manifestation of hepatic relapse within 6 months was 77% (10 of 13 patients), and the negative predictive value was 97% (35 of 36 patients). CONCLUSIONS: Indocyanine green-fluorescent imaging can detect hepatic micrometastases of pancreatic cancer during surgery. The hepatic micrometastases seem to have an adverse clinical impact identical to that of evident distant metastases. Cancer 2012;118:2813-

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“…15,16,21 Intravenously injected ICG binds to serum proteins and fluoresces in near-infrared light. The protein-bound ICG is excreted into the bile juice through hepatocytes.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Yokoyama

Otani

Hashidate

et al. 2011

Cancer

106

View full text Add to dashboard Cite

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“…In 117 patients, we thrombosis, the clinical usefulness of ICG-PDE has already been reported. [17][18][19][20][21][22] In patients with severe liver injury such as cirrhosis or those who underwent ICG administration within a few days, multiple false-positive fluorescent spots were observed. Anatomical resection of the liver can be needed under various circumstances, as described above.…”

mentioning

confidence: 99%

Usefulness of intraoperative diagnosis of hepatic tumors located at the liver surface and hepatic segmental visualization using indocyanine green-photodynamic eye imaging

Abo

Nanashima

Tobinaga

et al. 2015

European Journal of Surgical Oncology (EJSO)

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“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] A total of 718 cases were globally analyzed as study group. No side effects of ICG were reported in any articles.…”

Section: Resultsmentioning

confidence: 99%

Different ways to manage indocyanine green fluorescence to different purposes in liver surgery: A systematic review

et al. 2018

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Journal of Peritoneum (and other serosal surfaces) 2018; volume 3:96 AbstractFluorescent properties of indocyanine green (ICG) for hepatic tumor identification and features have been recently studied. The aim is to review the published data on the use of ICG enhanced fluorescence surgery during liver resection. A systematic search of literature was performed using MEDLINE, EMBASE, Cochrane and Web of Science libraries. For all eligible studies, the following data were extracted: study design, number of cases, management of indocyanine green (dose, time and method of administration), type of surgery, outcome variables, false positive and accuracy value, if reported. For statistical analysis, it was considered significant P<0.05, when published. 19 articles were fully analyzed and data were extracted. A total of 718 cases were globally analyzed as study group. No side effects of ICG were reported in any articles. 12 prospective observational, 1 randomized and 2 case-control studies were found. Three case reports and one experimental on animal model were also included. Detection of superficial lesions, segmental staining, biliary anatomy investigation (biliary leakage detection, biliary tree anatomy) were the main clinical application of fluorescence liver guided surgery. The overall quality of the data currently available is limited but the role of fluorescence guided liver surgery seems promising.

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Image‐Guided Liver Mapping Using Fluorescence Navigation System with Indocyanine Green for Anatomical Hepatic Resection

Abstract: We demonstrated here that near-infrared fluorescence imaging system is a novel and reliable intraoperative technique to identify hepatic segment and subsegment for anatomical hepatic resection.

Cited by 254 publications

References 21 publications

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Real‐time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging

Usefulness of intraoperative diagnosis of hepatic tumors located at the liver surface and hepatic segmental visualization using indocyanine green-photodynamic eye imaging

Different ways to manage indocyanine green fluorescence to different purposes in liver surgery: A systematic review

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