The diagnostic value of Near-Infrared Indocyanine Green Imaging for Endometriosis: A systematic review and meta-analysis

Abstract

Objective: To evaluate the diagnostic effect of Near-Infrared Indocyanine Green (ICG) imaging for Endometriosis(EMs). Methods: We searched Chinese National Knowledge Infrastructure (CNKI), Clinical Trials, WanFang Database, Web of Science, Cochrane Library, and Medline electronic databases up to January 2024. Reference lists of enrolled studies, Google Scholar, and reports of scientific meetings were also searched manually. Results: Through systematic literature search and screening, six studies compared the diagnostic effect of ICG imaging to White Light imaging(WL) for EMs during laparoscopic surgery were enrolled. Two studies found that ICG imaging improved the diagnostic rate of EMs. The others found the diagnostic value of ICG imaging was minimal. Cumulative results found the sensitivity is 0.88 (95%CI: 0.81-0.93) for WL and 0.64 (95%CI: 0.36-0.84) for ICG respectively. The specificity is 0.85 (95%CI: 0.49-0.97) for WL and 0.88 (95%CI: 0.66-0.97) for ICG respectively. The positive likelihood ratio (LR+) is 5.8 (95%CI: 1.4-24.5) for WL and 5.4 (95%CI: 1.2-24.1) for ICG respectively. The negative likelihood ratio (LR-) is 0.14 (95%CI: 0.09-0.20) for WL and 0.41 (95%CI: 0.18-0.94) for ICG respectively. The diagnostic odds ratio (DOR) is 42 (95%CI: 10-182) for WL and 13(95%CI: 1-124) for ICG respectively. Conclusion: Although ICG may be helpful for the visualization of occult EMs, the diagnostic value of ICG is nonsuperior to WL. However, the results should be minded with caution owing to the limited studies and small sample size. More reliable evidence based on larger simple-size studies and multicentric studies are needed urgently.