Green Fluorescence Imaging Technology Research Articles

Preliminary application of indocyanine green fluorescence imaging technology in nasal endoscopic tumor surgery

Objective:To preliminarily study the practical value of Indocyanine green（ICG） molecular fluorescence imaging technology in nasal endoscopic tumor surgery. Methods:Five patients with tumors related to nasal sinuses, orbital wall and skull base in the Department of Otolaryngology head and Neck Surgery, General Hospital of Xinjiang Military Command from December 2022 to April 2023 were enrolled. Among them, 3 were benign tumors and 2 were malignant tumors. All patients underwent surgery under the guidance of ICG molecular fluorescence imaging. ICG was administered intravenously through cubital vein at a dose of 0.5 mg/kg 12 to 24 h before surgery. Tumors were labeled by fluorescence imaging during the operation. surgeons cleared the tumor tissue strictly according to the labeled range and depth, malignant tumors were further expanded and cleaned according to pathology results. Results:All 5 patients achieved accurate tumor localization with the aid of fluorescence imaging technology. Resections were performed with reference to fluorescent labeling boundaries, all patients achieved complete tumor cleanup or negative margins. Conclusion:For tumor-related surgery under nasal endoscopy, ICG molecular fluorescence imaging technology can not only achieve accurate real-time positioning, but also provide evidence for surgeons to judge tumor boundaries. Therefore, we believe that the technology should have certain practical value in nasal endoscopic tumor surgery.

Chinese expert consensus on laparoscopic hepatic segmentectomy and subsegmentectomy navigated by augmented- and mixed-reality technology combined with indocyanine green fluorescence imaging

Abstract Augmented- and mixed-reality technologies have pioneered the realization of real-time fusion and interactive projection for laparoscopic surgeries. Indocyanine green fluorescence imaging technology has enabled anatomical, functional, and radical hepatectomy through tumor identification and localization of target hepatic segments, driving a transformative shift in the management of hepatic surgical diseases, moving away from traditional, empirical diagnostic and treatment approaches toward digital, intelligent ones. The Hepatic Surgery Group of the Surgery Branch of the Chinese Medical Association, Digital Medicine Branch of the Chinese Medical Association, Digital Intelligent Surgery Committee of the Chinese Society of Research Hospitals, and Liver Cancer Committee of the Chinese Medical Doctor Association organized the relevant experts in China to formulate this consensus. This consensus provides a comprehensive outline of the principles, advantages, processes, and key considerations associated with the application of augmented reality and mixed-reality technology combined with indocyanine green fluorescence imaging technology for hepatic segmental and subsegmental resection. The purpose is to streamline and standardize the application of these technologies.

Application of augmented reality navigation combined with indocyanine green fluorescence imaging technology in the accurate guidance of laparoscopic anatomical segment 8 liver resection

Objective: To investigate the application value of augmented reality navigation combined with indocyanine green(ICG) fluorescence imaging technology in laparoscopic anatomical segment 8 liver resection. Methods: Clinical and pathological data from 8 patients with hepatocellular carcinoma located in segment 8 of the liver admitted to the First Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University from October 2021 to October 2022 were collected restrospectively. Among them,there were 5 males and 3 females,aged between 40 and 72 years. During the operation,the self-developed laparoscopic augmented reality surgical navigation system was used to integrate the three-dimensional liver model with the laparoscopic scene,and ICG fluorescence imaging technology was used to guide the anatomical liver resection of segment 8. The predicted liver resection volume and actual liver resection volume,related surgical indicators and postoperative complications were analyzed. Results: Among the 8 patients, 4 underwent laparoscopic anatomical segment 8 liver resection,1 underwent laparoscopic anatomical ventral subsegment of segment 8 liver resection,2 underwent laparoscopic anatomical ventral subsegment combined with medial subsegment of segment 8 liver resection, and 1 underwent laparoscopic anatomical dorsal subsegment of segment 8 liver resection. All operations were completed under the guidance of augmented reality navigation combined with ICG fluorescence imaging,without conversion to open surgery. The operation time was (276.3±54.8)minutes(range:200 to 360 minutes). Intraoperative blood loss was (75.0±35.4)ml(range:50 to 150 ml). No blood transfusion was performed during the operation. The length of postoperative hospital stay was (7.6±0.8)days(range:7 to 9 days). There were no deaths or postoperative complications such as bleeding or biliary fistula during the perioperative period. Conclusion: Augmented reality navigation combined with ICG fluorescence imaging technology can guide the implementation of laparoscopic anatomical segment 8 liver resection.

Indocyanine green fluorescence imaging technology in minimally invasive liver resection

Indocyanine green fluorescence imaging technology in minimally invasive liver resection

Application of indocyanine green fluorescence imaging in open hepatectomy

Objective To investigate the clinical application of indocyanine green fluorescence imaging in open hepatectomy. Methods A total of forty-five patients who underwent liver resection in Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University from July 2017 to December 2018 were included in this prospective study. There were 26 males and 19 females, aged between 29 to 74 (51±10) years. Indocyanine green was injected intravenously 72~96 hours prior to surgery in all these patients. An intraoperative fluorescence imaging system was used to locate and remove the tumor, the liver parenchymal transection planes and surgical margins were detected by fluorescence again after tumor resection. The fluorescence profiles of the tumor specimens in relation to the tumor differentiation were analyzed. Results Indocyanine green fluorescence imaging was performed in 45 patients. A total of 66 lesions were detected by preoperative CT (or MRI), abdominal ultrasound and intraoperative fluorescence imaging. After excision of the primary liver cancer, the surgical margins of the remnant liver stumps and fluorescence in the excised liver specimens were studied. Thirteen small lesions were found in 10 patients, most of which were located at the surgical margin, and the smallest tumors detected were less than 5 mm in diameter. Five venous cancer emboli were found in 5 patients, 3 of which were not detected by preoperative imaging examinations. The fluorescence profile images of the excised hepatocellular carcinoma specimens showed homogeneous fluorescence in most highly differentiated hepatocellular carcinoma, and partial fluorescence or ring fluorescence in moderately differentiated hepatocellular carcinoma. Conclusion Indocyanine green fluorescence imaging technology can identify liver surface lesions, as well as detect small residual lesions at the cutting edge and venous thrombus, which improves the efficiency of hepatocellular carcinoma resection. Key words: Hepatectomy; Margins of excision; Indocyanine green; Fluorescence imaging

Application of indocyanine green fluorescence imaging in colorectal cancer surgery

Indocyanine green (ICG) fluorescence imaging has been widely used in surgery. In colorectal surgery specifically, more and more studies have shown that intraoperative fluorescence imaging is a safe and feasible method to assess anastomotic perfusion, and its use may decrease the incidence of anastomotic leakage. Meanwhile, indocyanine green can also be used to mark the location of lesion, identify sentinel lymph nodes, protect the ureter, and so on. It can also provide detection and guidance in the operation of peritoneal metastasis and liver metastasis of colorectal cancer. The application of indocyanine green fluorescence imaging can offer great value for surgery through improving the accuracy and outcomes of oncological resections. According to existing studies, we are still at an early application stage of indocyanine green fluorescence imaging technology in colorectal surgery. Lacking prospective randomized controlled studies, neither standards nor guidelines for injection dosage, site and observation period are satisfactory. Therefore, deep researches and establishment of standardized operational procedure are required to enhance the safety and accuracy of tumor resection and improve outcomes.

Effectiveness and safety of indocyanine green fluorescence imaging-guided hepatectomy for liver tumors: A systematic review and first meta-analysis.

This meta-analysis was conducted to evaluate the effectiveness and safety of indocyanine green fluorescence imaging-guided hepatectomy(FIGH) for liver tumors. Clinical studies were retrieved from the PubMed, Embase, Cochrane Library, Medline and Web of Science electronic databases. Primary outcomes included operative time, blood loss, blood transfusion, hospital stay, R0 resection, postoperative complications, postoperative mortality and 1-year recurrence rate. Study-specific effect sizes and their 95% confidence intervals (CIs) were combined to calculate the pooled value using a fixed-effects or random-effects model. Six studies comprising 587 patients were included. Major operative time (mean difference [MD] = -55.45; 95% CI = -78.85- -32.05), blood loss (MD = 12.99; 95% CI = 12.00-13.97), hospital stay (rate difference [RD] = -12.61; 95% CI = -15.06- -10.17), and postoperative complications (RD = -0.07; 95% CI = -0.12- -0.01) were all less in the FIGH group than in the traditional hepatectomy(TH) group. No differences were found in blood transfusion, R0 resection or 1-year recurrence rate. No perioperative mortality was observed in either group. Based on current evidence, applying indocyanine green fluorescence imaging technology to accurately diagnose and treat liver tumors can effectively reduce operative time, blood loss, hospital stay and postoperative complications.

Applications advance of indocyanine green florescence imaging in colorectal cancer patients undergoing hepatectomy for liver metastasis

It is difficult to detect micrometastasis of liver cancer with conventional imaging techniques, which leads to high recurrence rate after surgical excision in patients with colorectal cancer liver metastasis. The emergence of indocyanine green fluorescence imaging technology solves this problem. This article reviews the mechanism of this new technology, its clinical application in liver cancer resection and also discussed the advantages and limitations for indocyanine green fluorescence imaging technology. Key words: Colorectal neoplasms; Liver neoplasms; Hepatectomy; Indocyanine green(ICG); Florescence imaging

Indocyanine green fluorescence imaging technology for defining

Indocyanine green fluorescence imaging technology for defining