<p>NIR fluorescence-guided tumor surgery: new strategies for the use of indocyanine green</p>

Abstract

Surgery is the frontline treatment for a large number of cancers. The objective of these excisional surgeries is the complete removal of the primary tumor with sufficient safety margins. Removal of the entire tumor is essential to improve the chances of a full recovery. To help surgeons achieve this objective, near-infrared fluorescence-guided surgical techniques are of great interest. The concomitant use of fluorescence and indocyanine green (ICG) has proved effective in the identification and characterization of tumors. Moreover, ICG is authorized by the Food and Drug Administration and the European Medicines Agency and is therefore the subject of a large number of studies. ICG is one of the most commonly used fluorophores in near-infrared fluorescence-guided techniques. However, it also has some disadvantages, such as limited photostability, a moderate fluorescence quantum yield, a high plasma protein binding rate, and undesired aggregation in aqueous solution. In addition, ICG does not specifically target tumor cells. One way to exploit the capabilities of ICG while offsetting these drawbacks is to develop high-performance near-infrared nanocomplexes formulated with ICG (with high selectivity for tumors, high tumor-to-background ratios, and minimal toxicity). In this review article, we focus on recent developments in ICG complexation strategies to improve near-infrared fluorescence-guided tumor surgery. We describe targeted and nontargeted ICG nanoparticle models and ICG complexation with targeting agents.

Stroma-Rich Co-Culture Multicellular Tumor Spheroids as a Tool for Photoactive Drugs Screening

“…Further, near infra-red (NIR) fluorescent tracers such as Indocyanine Green (ICG) attracts attention in PDT and especially in PD due to the deep infrared light penetration across the tissues. ICG, one of the most common dyes used in NIR fluorescent image-guided surgery [28,29] was applied for sentinel node mapping and was considered effective for intraoperative imaging of head and neck lesions [30].…”

Indocyanine green fluorescence-guided intraoperative detection of peritoneal carcinomatosis: systematic review

“…Furthermore, we have not considered studies in which ICG is linked to molecules that bind directly to cancer cells. This field of research is very exciting from a theoretical point of view, and many papers have recently reported impressively favourable results; this strategy could make fluorescence a truly oncological navigation [ 33 , 36 – 38 ]; however, the need for an advanced molecular biology and biochemistry laboratory, ethical concern requiring IRB approval, high costs, make it still far from a practical application [ 39 ].…”

Indocyanine Green Fluorescence-guided intraoperative detection of peritoneal carcinomatosis: systematic review.

“…Furthermore, we have not considered studies in which ICG is linked to molecules that bind directly to cancer cells. This eld of research is very exciting from a theoretical point of view, and many papers have recently reported impressively favourable results; this strategy could make uorescence a truly oncological navigation [33,[36][37][38]; however, the need for an advanced molecular biology and biochemistry laboratory, ethical concern requiring IRB approval, high costs, make it still far from a practical application [39].…”