The use of indocyanine green imaging technique in patient with hepatocellular carcinoma

Huang, Shih-Wei; Ou, Jing‐Jim; Wong, Hon Phin

doi:10.21037/tgh.2018.10.15

Cited by 25 publications

(22 citation statements)

References 43 publications

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“…The absorption spectrum of ICG is in the near-infrared light (NIR). It emits protein-bound maximum fluorescence at about 840 nm when stimulated by near-infrared light [ 1 ], [ 2 ], [ 3 ]. After intravenous injection ICG binds to plasma proteins, especially albumin and alpha-1/beta-lipoproteins which are taken up by hepatocytes via organic anions-transporting polypeptides (OATP) and sodium taurocholate co-transporting polypeptides (NTCP).…”

Section: Introductionmentioning

confidence: 99%

Tumor visualization and fluorescence angiography with indocyanine green (ICG) in laparoscopic and robotic hepatobiliary surgery – valuation of early adopters from Germany

Franz

Arend

Wolff

et al. 2021

Innovative Surgical Sciences

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Objectives Indocyanine green (ICG) is a fluorescent dye which was initially used for liver functional assessment. Moreover, it is of value for intraoperative visualization of liver segments and bile ducts or primary and secondary liver tumors. Especially in minimally invasive liver surgery, this is essential to enhance the precision of anatomical guided surgery and oncological quality. As early adopters of ICG implementation into laparoscopic and robotic-assisted liver surgery in Germany, we summarize the current recommendations and share our experiences. Methods Actual strategies for ICG application in minimally invasive liver surgery were evaluated and summarized during a review of the literature. Experiences in patients who underwent laparoscopic or robotic-assisted liver surgery with intraoperative ICG staining between 2018 and 2020 from the Magdeburg registry for minimally invasive liver surgery (MD-MILS) were evaluated and the data were analyzed retrospectively. Results ICG can be used to identify anatomical liver segments by fluorescence angiography via direct or indirect tissue staining. Fluorescence cholangiography visualizes the intra- and extrahepatic bile ducts. Primary and secondary liver tumors can be identified with a sensitivity of 69–100%. For this 0.5 mg/kg body weight ICG must be applicated intravenously 2–14 days prior to surgery. Within the MD-MILS we identified 18 patients which received ICG for intraoperative tumor staining of hepatocellular carcinoma (HCC), cholangiocarcinoma, peritoneal HCC metastases, adenoma, or colorectal liver metastases. The sensitivity for tumor staining was 100%. In 27.8% additional liver tumors were identified by ICG fluorescence. In 39% a false positive signal could be detected. This occurred mainly in cirrhotic livers. Conclusions ICG staining is a simple and useful tool to assess individual hepatic anatomy or to detect tumors during minimally invasive liver surgery. It may enhance surgical precision and improve oncological quality. False-positive detection rates of liver tumors can be reduced by respecting the tumor entity and liver functional impairments.

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Section: Introductionmentioning

confidence: 99%

Tumor visualization and fluorescence angiography with indocyanine green (ICG) in laparoscopic and robotic hepatobiliary surgery – valuation of early adopters from Germany

Franz

Arend

Wolff

et al. 2021

Innovative Surgical Sciences

View full text Add to dashboard Cite

show abstract

“…The false-positive rate with ICG navigation surgery is reported to be 10–20% (number of lesions that were not pathologically diagnosed as HBs among ICG-positive lesions). Furthermore, in surveys of hepatocellular carcinoma, the sensitivity and specificity were reported to vary depending on the histology, liver function and timing of surgery after ICG injection [17,18,19,20]. In addition, the fluorescence produced by ICG can only be detected when the lesions are located 5–10 mm from the surface.…”

Section: Discussionmentioning

confidence: 99%

Living Donor Liver Re-Transplantation for Recurrent Hepatoblastoma in the Liver Graft following Complete Eradication of Peritoneal Metastases under Indocyanine Green Fluorescence Imaging

Takahashi

Yamada

Hoshino

et al. 2019

Cancers

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The curability of chemotherapy-resistant hepatoblastoma (HB) largely depends on the achievement of radical surgical resection. Navigation techniques utilizing indocyanine green (ICG) are a powerful tool for detecting small metastatic lesions. We herein report a patient who underwent a second living donor liver transplantation (LDLTx) for multiple recurrent HBs in the liver graft following metastasectomy for peritoneal dissemination with ICG navigation. The patient initially presented with ruptured HB at 6 years of age and underwent 3 liver resections followed by the first LDLTx with multiple sessions of chemotherapy at 11 years of age. His alpha-fetoprotein (AFP) level increased above the normal limit, and metastases were noted in the transplanted liver and peritoneum four years after the first LDLTx. The patient underwent metastasectomy of the peritoneally disseminated HBs with ICG navigation followed by the second LDLTx for multiple metastases in the transplanted liver. The patient has been recurrence-free with a normal AFP for 30 months since the second LDLTx. To our knowledge, this report is the first successful case of re-LDLTx for recurrent HBs. Re-LDLTx for recurrent HB can be performed in highly select patients, and ICG navigation is a powerful surgical tool for achieving tumor clearance.

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“…ICG-NIR fluorescence imaging has been applied also to intraoperative tumor detection in order to ensure a total tumor resection (Gotoh et al, 2009 ; Onda et al, 2016 ; Rossi et al, 2018 ). Indeed, exploiting ICG hepatic clearance and the enhanced permeability and retention (EPR) effect, liver tumors could be identified (Ishizawa et al, 2009 ; Huang et al, 2018 ).…”

Section: Icg As An Nir Fluorescent Contrast Agent: Clinical Applicatimentioning

confidence: 99%

Indocyanine Green Nanoparticles: Are They Compelling for Cancer Treatment?

et al. 2020

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Indocyanine green (ICG) is a Food and Drug Administration-approved near-infrared fluorescent dye, employed as an imaging agent for different clinical applications due to its attractive physicochemical properties, high sensitivity, and safety. However, free ICG suffers from some drawbacks, such as relatively short circulation half-life, concentration-dependent aggregation, and rapid clearance from the body, which would confine its feasible application in oncology. Here, we aim to discuss encapsulation of ICG within a nanoparticle formulation as a strategy to overcome some of its current limitations and to enlarge its possible applications in cancer diagnosis and treatment. Our purpose is to provide a short but exhaustive overview of clinical outcomes that these nanocomposites would provide, discussing opportunities, limitations, and possible impacts with regard to the main clinical needs in oncology.

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The use of indocyanine green imaging technique in patient with hepatocellular carcinoma

Cited by 25 publications

References 43 publications

Tumor visualization and fluorescence angiography with indocyanine green (ICG) in laparoscopic and robotic hepatobiliary surgery – valuation of early adopters from Germany

Tumor visualization and fluorescence angiography with indocyanine green (ICG) in laparoscopic and robotic hepatobiliary surgery – valuation of early adopters from Germany

Living Donor Liver Re-Transplantation for Recurrent Hepatoblastoma in the Liver Graft following Complete Eradication of Peritoneal Metastases under Indocyanine Green Fluorescence Imaging

Indocyanine Green Nanoparticles: Are They Compelling for Cancer Treatment?

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