Molecular fluorescence‐guided surgery of peritoneal carcinomatosis of colorectal origin: A narrative review

Hentzen, Judith E K R; Jongh, Steven J de; Hemmer, Patrick H. J.; Plas, Willemijn Y. van der; Dam, Gooitzen M. van; Kruijff, Schelto

doi:10.1002/jso.25106

Cited by 17 publications

(13 citation statements)

References 126 publications

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“…From a dosing point of view, virtually all series carry the same dosage (0.25 mg/kg), except one that carries twice and one that uses a fixed dose independently from weight (20 mg). All reported injected schedules are similar to that used in other areas for perfusion studies [19].…”

Section: Discussionmentioning

confidence: 81%

“…It is a low-cost molecule, easy to use, widely available and with negligible toxicity [17]. The use of ICG fluorescence in abdominal surgery has been introduced in recent years and represents a common tool for perfusion evaluation, extrahepatic bile duct anatomy, lymph node navigation and liver surgery [18][19][20]. ICG binds primarily to serum albumin and other serum globulins such as alpha1-lipoprotein, and then it circulates behaving like a macromolecule [21].…”

Section: Discussionmentioning

confidence: 99%

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Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

Baiocchi¹,

Gheza

Molfino

et al. 2020

Preprint

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BACKGROUND. To review the available clinical data about the value of Indocyanine Green (ICG) fluorescence imaging for intraoperative detection of peritoneal carcinomatosis. METHODS. We conducted a systematic review, according to the PRISMA guidelines, for clinical series investigating the possible role of ICG fluorescence imaging in detecting peritoneal carcinomatosis during surgical treatment of abdominal malignancies. Key words for search were “indocyanine green”, “carcinomatosis”, “peritoneum”, “fluorescence”. Papers including trials with fluorophores other than ICG were excluded. Papers including in vitro and experimental animals series were also excluded. We extracted data on patients and cancer features, timing, dose and modality of ICG administration, sensitivity, specificity and accuracy of fluorescence diagnosis of peritoneal nodules. RESULTS. Out of 192 screened papers, we finally retrieved 7 series reporting ICG-guided detection of peritoneal carcinomatosis. Two papers reported the same cases, thus only 6 series were analyzed, for a total of 71 patients. The investigated tumors were colorectal carcinomas in 28 cases, hepatocellular carcinoma in 16 cases, ovarian cancer in 26 cases and endometrial cancer in 1 case. In all but 4 cases, the clinical setting was an elective intervention in patients known as having peritoneal carcinomatosis. No series reported a laparoscopic procedure. Technical data of ICG management were consistent across the studies. Overall, 353 lesions were singularly analyzed and evaluated. Sensitivity varied from 72.4–100%, specificity from 54.2–100%. Two series reported that planned intervention changed in 25% and 29% of patients, respectively. CONCLUSION. Indocyanine Green based fluorescence of peritoneal carcinomatosis is a promising intraoperative tool for detection and characterization of peritoneal nodules in patients with colorectal, hepatocellular, ovarian carcinomas. Further prospective studies are needed, including stanging laparoscopy for pancreato-biliary, gastric cancer and other abdominal malignancies with frequent spread to peritoneum.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

Baiocchi¹,

Gheza

Molfino

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…After some initial cases, almost all the Authors injected ICG at the time of anesthesia induction and detected fluorescence starting from 5′ after the injection, for a rather long period (someone up to 360′). Some experimental observations suggested that the best timing for ICG visualization due to the EPR is 6 h after injection owing to the rapid clearance of ICG, resulting in a better tumor-to-background ratio starting after 6 h and lasting until 24 h [27]. In case of HCC the timing is different, as ICG is metabolized by normal hepatocytes and unexcreted because of bile ducts alteration, elightening the nodules even many days after the injection.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

View full text Add to dashboard Cite

Background: To review the available clinical data about the value of Indocyanine Green (ICG) fluorescence imaging for intraoperative detection of peritoneal carcinomatosis. Methods: We conducted a systematic review, according to the PRISMA guidelines, for clinical series investigating the possible role of ICG fluorescence imaging in detecting peritoneal carcinomatosis during surgical treatment of abdominal malignancies. With the aim to analyze actual application in the daily clinical practice, papers including trials with fluorophores other than ICG, in vitro and animals series were excluded. Data on patients and cancer features, timing, dose and modality of ICG administration, sensitivity, specificity and accuracy of fluorescence diagnosis of peritoneal nodules were extracted and analyzed. Results: Out of 192 screened papers, we finally retrieved 7 series reporting ICG-guided detection of peritoneal carcinomatosis. Two papers reported the same cases, thus only 6 series were analyzed, for a total of 71 patients and 353 peritoneal nodules. The investigated tumors were colorectal carcinomas in 28 cases, hepatocellular carcinoma in 16 cases, ovarian cancer in 26 cases and endometrial cancer in 1 case. In all but 4 cases, the clinical setting was an elective intervention in patients known as having peritoneal carcinomatosis. No series reported a laparoscopic procedure. Technical data of ICG management were consistent across the studies. Overall, 353 lesions were harvested and singularly evaluated. Sensitivity varied from 72.4 to 100%, specificity from 54.2 to 100%. Two series reported that planned intervention changed in 25 and 29% of patients, respectively. Conclusion: Indocyanine Green based fluorescence of peritoneal carcinomatosis is a promising intraoperative tool for detection and characterization of peritoneal nodules in patients with colorectal, hepatocellular, ovarian carcinomas. Further prospective studies are needed to fix its actual diagnostic value on these and other abdominal malignancies with frequent spread to peritoneum.

show abstract

“…Some experimental observations suggested that the best timing for ICG visualization due to the EPR is 6 hours after injection owing to the rapid clearance of ICG, resulting in a better tumor-to-background ratio starting after 6 hours and lasting until 24 hours [27]. In case of HCC the timing is different, as ICG is metabolized by normal hepatocytes and unexcreted because of bile ducts alteration, elightening the nodules even many days after the injection.…”

Section: Discussionmentioning

confidence: 99%

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

Baiocchi¹,

Gheza

Molfino

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract BACKGROUND. To review the available clinical data about the value of Indocyanine Green (ICG) fluorescence imaging for intraoperative detection of peritoneal carcinomatosis. METHODS. We conducted a systematic review, according to the PRISMA guidelines, for clinical series investigating the possible role of ICG fluorescence imaging in detecting peritoneal carcinomatosis during surgical treatment of abdominal malignancies. With the aim to analyze actual application in the daily clinical practice, papers including trials with fluorophores other than ICG, in vitro and animals series were excluded. Data on patients and cancer features, timing, dose and modality of ICG administration, sensitivity, specificity and accuracy of fluorescence diagnosis of peritoneal nodules were extracted and analyzed. RESULTS. Out of 192 screened papers, we finally retrieved 7 series reporting ICG-guided detection of peritoneal carcinomatosis. Two papers reported the same cases, thus only 6 series were analyzed, for a total of 71 patients and 353 peritoneal nodules. The investigated tumors were colorectal carcinomas in 28 cases, hepatocellular carcinoma in 16 cases, ovarian cancer in 26 cases and endometrial cancer in 1 case. In all but 4 cases, the clinical setting was an elective intervention in patients known as having peritoneal carcinomatosis. No series reported a laparoscopic procedure. Technical data of ICG management were consistent across the studies. Overall, 353 lesions were harvested and singularly evaluated. Sensitivity varied from 72.4% to 100%, specificity from 54.2% to 100%. Two series reported that planned intervention changed in 25% and 29% of patients, respectively. CONCLUSION. Indocyanine Green based fluorescence of peritoneal carcinomatosis is a promising intraoperative tool for detection and characterization of peritoneal nodules in patients with colorectal, hepatocellular, ovarian carcinomas. Further prospective studies are needed to fix its actual diagnostic value on these and other abdominal malignancies with frequent spread to peritoneum.

show abstract

Molecular fluorescence‐guided surgery of peritoneal carcinomatosis of colorectal origin: A narrative review

Cited by 17 publications

References 126 publications

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

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

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

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