A narrative review of indocyanine green near-infrared fluorescence imaging technique: a new application in thoracic surgery

Abstract

: In clinical work of thoracic surgery, accurate anatomic location of pulmonary nodules, precise demarcation of segmental and sub-segmental plane, tracing of sentinel lymph nodes (SLNs), protection of thoracic nerve, averting of anastomotic fistula etc. always puzzling the surgeons. Indocyanine green (ICG) is a near-infrared fluorescence (NIRF) contrast agent that is the only reagent approved by the Food and Drug Administration (FDA) for use in human subjects due to its low toxicity and high absorbance in the near-infrared spectrum. The application of ICG NIRF imaging technology in surgery is safe and feasible, it can offer real-time fluorescing information and help surgeons make important decisions during surgery. Many studies demonstrated that ICG NIRF can be used to determine tissue perfusion, lymphatic reflux and other fields. In recent years, it has been reported in the field of thoracic surgery and got success. It can provide more information compared to conventional video-assisted thoracoscopic surgery (VATS). In this review, the research results of this technique in animal models and clinical trials in recent years are reviewed the application of ICG NIRF technique in accurate positioning of pulmonary nodules, precise demarcation of segmental and sub-segmental plane, SLNs tracing, thoracic nerve protection, anastomotic leakage and chylothorax prevention.