Literature DB >> 20734045

Combined use of contrast-enhanced intraoperative ultrasonography and a fluorescence navigation system for identifying hepatic metastases.

Kazuhisa Uchiyama1, Masaki Ueno, Satoru Ozawa, Sigehisa Kiriyama, Yoshinobu Shigekawa, Hiroki Yamaue.   

Abstract

BACKGROUND: The purpose of this study was to assess the concomitant use of contrast-enhanced intraoperative ultrasound (CE-IOUS) using the new microbubble agent Sonazoid, and to assess the fluorescence navigation system (Photo Dynamic Eye, or PDE) using indocyanine green (ICG) as a novel tool for identifying colorectal metastatic lesions compared with preoperative contrast-enhanced multiple row-detected computed tomography (MDCT) and gadoxetic acid-enhanced MRI.
METHODS: Thirty-two patients who underwent a liver resection for colorectal metastatic carcinoma from 2008 to 2009 were included in the present study. ICG was intravenously injected within 2 weeks of the operation. The liver was inspected with CE-IOUS using Sonazoid and PDE for visualizing small metastatic lesions. A lesion analysis was performed with the postoperative histopathological examination of the resected tissues. The clinical values of CE-IOUS and PDE to confirm the malignant lesion diagnoses were statistically evaluated.
RESULTS: A total of 56 lesions were identified based on the histopathological findings of the biopsies and resected tissues; of these, 52 were confirmed to be metastases, whereas 4 were benign tumors. The numbers of identified metastases by MDCT/MRI and CE-IOUS/PDE were 46 and 51, respectively. The use of CE-IOUS and PDE improved the diagnostic sensitivity compared with the use of MDCT and EOB-MRI (98.1 vs. 88.5%, respectively; P = 0.050).
CONCLUSIONS: The present results suggested that the concomitant use of CE-IOUS with the Sonazoid and PDE system may be a useful and safe method, in addition to CT or MRI.

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Year:  2010        PMID: 20734045     DOI: 10.1007/s00268-010-0764-1

Source DB:  PubMed          Journal:  World J Surg        ISSN: 0364-2313            Impact factor:   3.352


  17 in total

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Review 3.  Image-guided cancer surgery using near-infrared fluorescence.

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4.  Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection.

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5.  Comparison of Regeneration of Remnant Liver After Hemihepatectomy with or Without the Middle Hepatic Vein.

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6.  Near-infrared fluorescence-guided resection of colorectal liver metastases.

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8.  Combined use of intraoperative ultrasound and indocyanine green fluorescence imaging to detect liver metastases from colorectal cancer.

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Review 10.  Current status and future perspectives of fluorescence-guided surgery for cancer.

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