Kosuke Kobayashi1, Yoshikuni Kawaguchi2, Yuta Kobayashi1, Masaru Matsumura1, Takeaki Ishizawa1, Nobuhisa Akamatsu1, Junichi Kaneko1, Junichi Arita1, Yoshihiro Sakamoto3, Norihiro Kokudo4, Kiyoshi Hasegawa5. 1. Hepato-Pancreatico-Biliary Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Japan. 2. Hepato-Pancreatico-Biliary Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Japan. Electronic address: yokawaguchi-tky@umin.ac.jp. 3. Hepato-Pancreatico-Biliary Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Japan; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Kyorin University Hospital, Tokyo, Japan. 4. Hepato-Pancreatico-Biliary Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Japan; Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan. 5. Hepato-Pancreatico-Biliary Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Japan. Electronic address: kihase-tky@umin.ac.jp.
Abstract
BACKGROUND: Fluorescence imaging using indocyanine green (ICG) enables intraoperatively visualizing liver tumors as fluorescent. This study evaluated the doses and timing of ICG administration for visualizing tumors via fluorescence using near-infrared light camera systems. METHODS: Consecutive patients who underwent open liver resection for liver tumors from 2016 to 2017 were included. ICG was intravenously injected one-day before surgery at 0.25 mg-intravenous injection (IV), 1.25 mg-IV, 2.5 mg-IV, or 3.75 mg-IV. No additional ICG was administered when patients underwent ICG (0.5 mg/kg) retention test within 10 preoperative days. The ability of fluorescence imaging to enable identifying liver tumors was compared using the PDE-NEO and PINPOINT. RESULTS: 154 lesions in 82 patients were assessed. The tumor identification rate of PDE-NEO did not differ significantly among dosages. The positive predictive values of PDE-NEO were significantly lower at 3.75 mg-IV (69.0%) than in the control group (92.0%) (p = 0.036) and at 1.25 mg-IV (88.9%) (p = 0.033). The tumor identification rate of PINPOINT was significantly higher at 3.75 mg-IV (82.4%) than at 1.25 mg-IV (60.0%) (p = 0.035). The positive predictive values of PINPOINT did not significantly differ among dosages. CONCLUSION: Administering 2.5 mg of ICG one-day before surgery can enable identifying tumors via fluorescence imaging when the ICG test was not performed within 10 preoperative days.
BACKGROUND: Fluorescence imaging using indocyanine green (ICG) enables intraoperatively visualizing liver tumors as fluorescent. This study evaluated the doses and timing of ICG administration for visualizing tumors via fluorescence using near-infrared light camera systems. METHODS: Consecutive patients who underwent open liver resection for liver tumors from 2016 to 2017 were included. ICG was intravenously injected one-day before surgery at 0.25 mg-intravenous injection (IV), 1.25 mg-IV, 2.5 mg-IV, or 3.75 mg-IV. No additional ICG was administered when patients underwent ICG (0.5 mg/kg) retention test within 10 preoperative days. The ability of fluorescence imaging to enable identifying liver tumors was compared using the PDE-NEO and PINPOINT. RESULTS: 154 lesions in 82 patients were assessed. The tumor identification rate of PDE-NEO did not differ significantly among dosages. The positive predictive values of PDE-NEO were significantly lower at 3.75 mg-IV (69.0%) than in the control group (92.0%) (p = 0.036) and at 1.25 mg-IV (88.9%) (p = 0.033). The tumor identification rate of PINPOINT was significantly higher at 3.75 mg-IV (82.4%) than at 1.25 mg-IV (60.0%) (p = 0.035). The positive predictive values of PINPOINT did not significantly differ among dosages. CONCLUSION: Administering 2.5 mg of ICG one-day before surgery can enable identifying tumors via fluorescence imaging when the ICG test was not performed within 10 preoperative days.
Authors: Anne-Sophie Mehdorn; Florian Richter; Katharina Hess; Jan Henrik Beckmann; Jan-Hendrik Egberts; Michael Linecker; Thomas Becker; Felix Braun Journal: J Clin Med Date: 2022-06-19 Impact factor: 4.964
Authors: Anne-Sophie Mehdorn; Jan Henrik Beckmann; Felix Braun; Thomas Becker; Jan-Hendrik Egberts Journal: J Clin Med Date: 2021-01-25 Impact factor: 4.241