Green Image Research Articles

Application of Indocyanine Green Fluorescence Imaging in Assisting Biopsy of Musculoskeletal Tumors

(1) Background: Biopsies are the gold standard for the diagnosis of musculoskeletal tumors. In this study, we aimed to explore whether indocyanine green near-infrared fluorescence imaging can assist in the biopsy of bone and soft tissue tumors and improve the success rate of biopsy. (2) Method: We recruited patients with clinically considered bone and soft tissue tumors and planned biopsies. In the test group, indocyanine green (0.3 mg/kg) was injected. After identifying the lesion, a near-infrared fluorescence camera system was used to verify the ex vivo specimens of the biopsy in real time. If the biopsy specimens were not developed, we assumed that we failed to acquire lesions, so the needle track and needle position were adjusted for the supplementary biopsy, and then real-time imaging was performed again. Finally, we conducted a pathological examination. In the control group, normal biopsy was performed. (3) Results: The total diagnosis rate of musculoskeletal tumors in the test group was 94.92% (56/59) and that in the control group was 82.36% (42/51). In the test group, 14 cases were not developed, as seen from real-time fluorescence in the core biopsy, and then underwent the supplementary biopsy after changing the puncture direction and the location of the needle channel immediately, of which 7 cases showed new fluorescence. (4) Conclusions: Using the near-infrared fluorescence real-time development technique to assist the biopsy of musculoskeletal tumors may improve the accuracy of core biopsy and help to avoid missed diagnoses, especially for some selected tumors.

Laparoscopic deroofing of simple liver cysts: do ancillary techniques, surgical devices, and indocyanine green improve outcomes?

Summary Background Giant liver cysts causing compression symptoms require surgical therapy. Laparoscopy is nowadays considered the first-line approach and has been shown to be non-inferior to open surgery. Ancillary techniques and novel technologies may have the potential to reduce complications rates and improve long-term outcomes. Methods The management of a female patient with a giant and symptomatic liver cyst is reported, as is a literature search in PubMed and Scopus spanning the past two decades, with the aim of assessing current evidence regarding procedural details of laparoscopic deroofing. Results Wide laparoscopic deroofing of a 21-cm liver cyst arising from segment 6 was safely performed under indocyanine green fluorescence imaging using a combination of ultrasonic energy excision and stapling. A contemporary literature review showed that only 22 of the 35 publications included details of the surgical procedure. Ancillary techniques such as omentopexy, argon plasma coagulation, monopolar radiofrequency device ablation, and ethanol sclerotherapy were rarely used (10.8% of patients). Use of energy devices and/or linear staplers was reported in 22 (62.8%) studies. Indocyanine green fluorescence was reported in 4 (11.4%) studies. Conclusion The case report and the literature review show that wide laparoscopic deroofing of giant liver cysts is an effective and relatively simple procedure. Use of emerging technology such as indocyanine green fluorescence imaging can further enhance precision surgery and minimize complications and long-term recurrence rates.

Featured Cover

The cover image is based on the Case Report Indocyanine green fluorescence imaging as an adjunct for the localization of a bile leak after split liver transplantation by Caroline P. Lemoine et al., https://doi.org/10.1111/petr.14431.

The Use of Indocyanine Green and Near-Infrared Fluorescence Imaging Versus Blue Dye in Sentinel Lymph Node Biopsy in Cutaneous Melanoma: A Retrospective, Cohort Study.

The use of indocyanine green (ICG) and near-infrared fluorescence imaging is a promising option for sentinel lymph node (SLN) mapping in cutaneous melanoma. The study objective was to compare the performance of ICG and blue dye at detecting SLNs with radioisotope nanocolloid (technetium-99). Between April 2018 and June 2022, 293 consecutive patients with cutaneous melanoma (Breslow thickness ≥ 0.8mm) underwent wide local excision and SLN biopsy. Patients were divided into group A (ICG; n = 122) and group B (blue dye; n = 163). All patients underwent SPECT/CT imaging preoperatively. SLN detection parameters and complications were compared between the groups. A total of 285 patients had complete data and were included in the analysis. The median age was 62.0 (range 10-91) years, and 139 (48.8%) were female patients. The mean Breslow thickness was 2.6mm, 89 (31.2%) patients had ulceration, and 179 (62.8%) patients had mitosis ≥ 1mm2. The mean number of SLNs detected per patient in group A was 1.58 and group B was 1.48. In groups A and B, the SLN detection rate was 96.7% versus 89.6% (p = 0.022) and the pathological SLN detection rate was 92.3% versus 97.1% (p = 0.481), respectively. ICG had a higher SLN detection rate and equal pathological SLN detection rate to blue dye. ICG may not be inferior to blue dye and is a useful adjunct to radioisotope in SLN biopsy in cutaneous melanoma.

Profilometry by zero-order interference fringe identification in the Commission Internationale de l’Eclairage system

In this study, a numerical procedure is proposed to determine the optical contact (peak of the coherence function) in a scanning white light interferential microscope. The Red, Green and Blue image of the correlogram is transformed to the Commission Internationale de l’Eclairage chromatic system with coordinates. The key element is to track the orientation of the curve (trajectory) which exhibits changes as it passes through the optical contact. The path described by the interferogram in this chromatic space makes it possible to localize, without ambiguity, the zero-order fringe and from this information to reconstruct the topography of an object of the order of a few tens of nanometres.

Effectiveness of indocyanine green fluorescence imaging in resection of hepatoblastoma.

The present research aimed to analyze the application of indocyanine green (ICG) fluorescence contrast technique in the resection of hepatoblastoma (HB) in children, and to discuss the use of ICG in the surgery of HB and the value of guidance. We retrospectively analyzed the data of 23 children with HB resected using ICG fluorescence contrast technique at the Children's Hospital of Nanjing Medical University from June 2020 to September 2022, including 16 boys and 7 girls, aged 5days to 80months. The patients were administered with an ICG injection of 0.1mg/kg around 24-48h before surgery. The surgical margin was detected by real-time fluorescence imaging and confirmed by postoperative pathology. All primary lesions showed bright fluorescence in 23 HB cases. 22 had clear borders with normal liver tissue, while one neonatal case showed no difference between tumor and background. 13 anatomic resection and 10 non-anatomic resection were performed with ICG fluorescence navigation. The surface of the residual liver was scattered with multiple tumor fluorescence, which was then locally enucleated according to the fluorescence. 22 isolated specimens were dissected and fluorescently visualized. Pathology identified deformed, vacuolated and densely arranged hepatocytes resembling pseudo-envelope changes without tumor residual, due to the compression of the tissue at the site of circumferential imaging. The ring ICG fluorescence imaging of HB indicates the tumor resection boundary effectively, especially in multiple lesions cases.

From networking orientation to green image: A sequential journey through relationship learning capability and green supply chain management practices. Evidence from the automotive industry

Drawing on the resource-based view of the firm (RBV) and resources and capabilities theory, this study develops a model that extends our understanding of the mechanisms through which strategic assets, capabilities, and green supply chain management practices (GSCMP) contribute to green image (GI). The model comprises (i) two new antecedents of GSCMP: relationship learning capability (RL) and strategic networking orientation (NO), and (ii) the direct and mediated impacts of GSCMP and their antecedents on firms' GI. To empirically study the proposed relationships, data were collected from 106 Spanish firms in the automotive industry and analyzed using partial least squares structural equation modelling (PLS-SEM). The results indicate that NO, RL capability, and GSCMP positively affect GI through a sequential mediation relationship. An important implication is the identification of a stream of research proposing that GSCMP act similarly to a lower-order capability and that it is the interaction with other ordinary capabilities that can contribute to improving the green image.

Clinical association between intraoperative ICG fluorescence imaging pattern, preoperative Gd-EOB-DTPA-enhanced MRI findings and histological differentiation in hepatocellular carcinoma.

We aimed to evaluate the association between the intraoperative indocyanine green (ICG) fluorescence imaging (FI) pattern, preoperative magnetic resonance imaging (MRI) findings using gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA), preoperative diffusion-weighted imaging (DWI) of MRI and histological differentiation of HCC. We retrospectively reviewed the data for 80 tumors of 64 patients. ICG FI patterns were classified into cancerous or rim-positive type. We evaluated the signal intensity ratio of the tumor and the surrounding liver tissue in the portal phase (SIRPP) and intensity in the hepatobiliary phase (HBP) of Gd-EOB-DTPA-enhanced MRI, the apparent diffusion coefficient (ADC) in the DWI of MRI and clinicopathological factors. In rim-positive group, the rate of poorly differentiated HCC and hypointensity type in HBP were significantly higher, and SIRPP and ADC were significantly lower than rim-negative group. In cancerous group, the rate of well or moderately differentiated HCC and hyperintensity type in HBP, SIRPP and ADC were significantly higher than non-cancerous group. Multivariate analysis identified low SIRPP, low ADC, and hypointensity type in HBP as the significant predictive factors for rim-positive HCC and high SIRPP, high ADC and hyperintensity type in HBP as the significant predictive factors for cancerous HCC. The positive rate of PD-L1 and VETC status of the rim-positive HCC and the HCC with low SIRPP were significantly higher than the control group. The intraoperative ICG FI pattern of HCC closely correlated with histological differentiation, preoperative SIRPP and intensity type in the Gd-EOB-DTPA MRI and preoperative ADC in the DWI of MRI. This article is protected by copyright. All rights reserved.

Usefulness of indocyanine green fluorescence-guided small intestinal bleeding site identification in small bowel resection: a report of two cases and literature review.

Small bowel bleeding that does not respond to conservative therapy requires surgical resection. However, identifying the bleeding sites intraoperatively is challenging. Indocyanine green (ICG) fluorescence imaging improves diagnosis of small bowel bleeding and surgical decision-making by visualizing blood flow. Herein, we reported two cases of small bowel bleeding that were successfully treated by using ICG to identify the bleeding sites and determine the extent of small bowel resection. The patients were a 46-year-old and a 75-year-old woman, both of whom presented with melena. Contrast-enhanced computed tomography and arteriography confirmed small bowel bleeding, and rebleeding occurred in both patients after transcatheter arterial embolization. Emergent surgeries were performed, and intraoperative selective angiography with ICG injections was conducted to identify obscure bleeding sites. ICG fluorescence identified all bleeding sites in both cases, and small bowel resections were successfully performed. The postoperative courses were uneventful, and both patients had a favorable postoperative course without recurrence of bleeding. ICG fluorescence imaging can safely identify the sites of intestinal bleeding and determine the appropriate extent of bowel resection.

Use of quantitative indocyanine green near-infrared fluorescence imaging in bariatric surgery: early results

Introduction Indocyanine green fluorescence angiography (ICG-FA) is commonly used in general surgery, but its use in bariatric surgery is still marginal. Moreover, post-operative leaks remain a dramatic complication after this surgery and the leak tests available have poor performance preventing them. The aim of the present paper is to assess the use and utility of a new innovative technology based on quantitative measures of fluorescence signal intensity. Material and methods From January 2022 to June 2022, 40 consecutive patients with a median age of 51 years and a preoperative median body mass index of 45.2 kg/m2 underwent bariatric surgery with quantitative ICG fluorescence angiography in our center. Two different types of surgery, based on the multidisciplinary evaluation, were performed: laparoscopic sleeve gastrectomy (LSG) and one anastomosis gastric bypass (OAGB). For ICG visualization, quantitative laparoscopic ICG platform was used to identify the vascular supply. Results Thirteen patients underwent LSG and 27 patients underwent OAGB. ICG was performed in all patients with no adverse events. An adequate and satisfactory blood supply was assessed in each case. No case of post-operative leak was detected. Conclusions The quantitative ICG-FA seems to be a useful and promising tool for the prevention of complications in bariatric surgery but further studies are mandatory.

How does environmental corporate social responsibility contribute to the development of a green corporate image? The sequential mediating roles of employees' environmental passion and pro‐environmental behavior

AbstractDrawing on social cognitive theory and social information processing theory, this study investigated how organizations' efforts to embody environmental corporate social responsibility (ECSR) shape consumer perception of a green corporate image through employees' environmental passion and pro‐environmental behavior (PEB). To test our hypotheses, we collected multisource time‐lagged data from 214 employee–customer dyads from hotel and banking sector organizations in Pakistan. The findings show that organizations' green corporate image is a function of their efforts to engage in ECSR activities as demonstrated through employees' environmental passion and PEB. These findings have important implications in the environment and management domains because it can help organizations draft useful strategies to counter environmental degradation and generate a green corporate image in customers' minds through employees' green behavior.

Green Product, Green Corporate Image, and Green Customer Loyalty at Hotel Indigo Bali Seminyak Beach

Purpose: This study aims to analyze the effect of the application of green product quality and green corporate image on green customer loyalty at Hotel Indigo Bali Seminyak Beach. 
 Research methods: The data collection methods used are observations, interviews, questionnaires, and literature studies. The respondents in this study were 50 guests who stayed at Hotel Indigo Bali Seminyak Beach using the method of determining purposive sampling or sampling based on certain characteristics. The data analysis techniques used are descriptive qualitative and multiple regression analysis. A validity and reliability test was carried out on the questionnaire distributed to the respondents.
 Result and discussion: Based on the results of the t test that has been carried out, it was concluded that the two partially free variables have a positive influence on green customer loyalty at Hotel Indigo Bali Seminyak Beach. Green product quality is more dominant in affecting green customer loyalty compared to green corporate image because in reality guests staying at the hotel look more at how the quality of products or services offered by the hotel so that guests can decide to buy the product continuously.
 Implications: Green product quality and green corporate image together or simultaneously have a positive and significant effect on green customer loyalty.

The Role of Green Trust as an Intervening Variable in the Relationship Between Green Brand Image and Green Perceived Value Towards Purchase Intention in Indonesian Local Fashion Products

The issue of environmental damage caused by fashion industry continues to increasing every year accompanied by real conditions that accur, either damage on humans, animals, plants, and the environment. Nowadays people are increasingly aware of the importance of preserving the environment more selectively in the selection of products used. This resesrch was conducted to determine the effect of Green Perceived Value and Green Brand Image on Green Purchase Intentionwith Green Trust as an Intervening variable in the case study on fashion product Sejauh Mata Memandang. The number of samples study werw 170 respondent from consumers Sejauh Mata Memandang and also green consumerism. The technique used in this research is purposive sampling. In this study, it shows that the Green Perceived Value and Green Brand Image variables have a significant effect on Green Trust and also Green Purchase Intention. Green Trust does not have a greater influence on each independent variable and also the dependent variable.

Sustainable luxury: from an oxymoron to a tautology – the case of the Indian luxury hospitality industry

PurposeIn the context of heightened awareness and understanding of responsible tourism, it has become increasingly imperative for luxury hotels to introspect on the impact of their operations on environmental and social sustainability. This study aims at examining the prevalence and growth of sustainability practices in the Indian luxury hotel segment as it increasingly competes on a global platform.Design/methodology/approachThe research approach adopted in this paper is qualitative and emic. Primary data is gathered for the study through semi-structured interviews with select luxury hotel general managers from four hotel chains of Indian origin – ITC Luxury Hotels, Oberoi Hotels and Resorts, Taj Hotels and Palaces and The Leela – to gain an insight into sustainability initiatives adopted in the Indian hospitality industry. Secondary research data regarding the eco-friendly, green measures implemented in these hotels is collected primarily from the websites of the respective hotel chains and supplemented by review of academic literature, media articles, industry reports and company press releases.FindingsThe findings of the study reveal that Indian luxury hotel brands are increasingly adopting green products and integrating innovative sustainability practices in their day-to-day operations. However, several of these initiatives are in the non-customer-facing domains such as the engineering and back-of-the-house operations. Very few Indian hotel chains are building these sustainability initiatives into their core philosophy and embedding it in the front-line customer service experience at their properties to reinforce the green image of the hotels.Originality/valueThe paper also proposes the 6Cs Framework of Sustainability that can be utilised to categorise the green sustainable practices adopted in responsible hotels in a simplistic manner under six broad verticals. Practitioners, researchers and educationists in the hospitality industry would find the implications of this study useful in the context of a post-pandemic world where sustainability is influencing consumer choices across industries in today’s eco-conscious and enlightened business and marketing environment.

Image-based phenotyping to estimate anthocyanin concentrations in lettuce.

Anthocyanins provide blue, red, and purple color to fruits, vegetables, and flowers. Due to their benefits for human health and aesthetic appeal, anthocyanin content in crops affects consumer preference. Rapid, low-cost, and non-destructive phenotyping of anthocyanins is not well developed. Here, we introduce the normalized difference anthocyanin index (NDAI), which is based on the optical properties of anthocyanins: high absorptance in the green and low absorptance in the red part of the spectrum. NDAI is determined as (Ired - Igreen)/(Ired + Igreen), where I is the pixel intensity, a measure of reflectance. To test NDAI, leaf discs of two red lettuce (Lactuca sativa) cultivars 'Rouxai' and 'Teodore' with wide range of anthocyanin concentrations were imaged using a multispectral imaging system and the red and green images were used to calculate NDAI. NDAI and other commonly used indices for anthocyanin quantification were evaluated by comparing to with the measured anthocyanin concentration (n = 50). Statistical results showed that NDAI has advantages over other indices in terms of prediction of anthocyanin concentrations. Canopy NDAI, obtained using multispectral canopy imaging, was correlated (n = 108, R2 = 0.73) with the anthocyanin concentrations of the top canopy layer, which is visible in the images. Comparison of canopy NDAI from multispectral images and RGB images acquired using a Linux-based microcomputer with color camera, showed similar results in the prediction of anthocyanin concentration. Thus, a low-cost microcomputer with a camera can be used to build an automated phenotyping system for anthocyanin content.

Indocyanine green fluorescence imaging to localize insulinoma and provide three-dimensional demarcation for laparoscopic enucleation: a retrospective single-arm cohort study.

Indocyanine green (ICG) fluorescence imaging is a new technology that can improve the real-time location of tumor edges and small nodules during surgery. However, no study has investigated its application in laparoscopic insulinoma enucleation. This study aimed to evaluate the feasibility and accuracy of this method for intraoperative localization of insulinomas and margin assessment during laparoscopic insulinoma enucleation. Eight patients who underwent laparoscopic insulinoma enucleation from October 2016 to June 2022 were enrolled. Two methods of ICG administration, ICG dynamic perfusion and three-dimensional (3D) demarcation staining, were utilized in the laparoscopic insulinoma enucleation. Tumor-to-background ratio (TBR) and histopathologic analysis were used to evaluate the feasibility and accuracy of these novel navigation methods in laparoscopic insulinoma enucleation. All eight enrolled patients underwent both ICG dynamic perfusion and 3D demarcation staining. ICG dynamic perfusion images were available for six of them, among which five tumors could be recognized by TBR (largest TBR in each case 4.42±2.76), while the other could be distinguished by the disordered blood vessels in the tumor area. Seven out of eight specimens had successful 3D demarcation staining (TBR 7.62±2.62). All wound bed margins had negative frozen sections and final histopathologic diagnoses. ICG dynamic perfusion may be helpful in observing the abnormal vascular perfusion of tumors, providing similar functionality to intraoperative real-time angiography. ICG injection under the tumor pseudocapsule may be a useful method for acquiring real-time, 3D demarcation for the resection of insulinoma.

A narrative review of intraoperative use of indocyanine green fluorescence imaging in gastrointestinal cancer: situation and future directions.

As a surgical tool, indocyanine green (ICG) is increasingly used in surgery, especially in gastric and colorectal surgery. The use of ICG fluorescence imaging can improve the accuracy of tumor resection and potentially improve surgical outcomes for cancer patients. However, there are still different opinions or controversies on the application of ICG in the literature and the administration of ICG is still not uniform. In this review, we summarize the current status of its application and ICG administration methods in gastrointestinal cancer and discuss its existing limitations and future research directions. Literature published in the PubMed database from 1969 to 2022 was searched for using the keywords "Indocyanine green or near-infrared imaging or ICG", "gastric cancer", "gastroesophageal junction cancer", and "colorectal cancer" to summarize the main applications of ICG in gastrointestinal cancers. ICG guidance can rapidly determine tumor location and save operative time, and can also visualize lymph nodes (LNs) in real-time, helping surgeons to retrieve more LNs for better postoperative staging, but its use in identifying sentinel lymph node (SLN) in gastric cancer (GC) remains controversial due to false negatives. ICG fluorescent angiography has great potential in preventing colorectal anastomotic leakage, but there is a dearth of high-caliber research evidence. In addition, ICG has unique advantages in detecting colorectal liver micrometastasis. Notably, there is still no uniform administration method and dose of ICG. In this review, we summarize the current status of ICG application in gastrointestinal cancer, and the current literature suggests that it is safe and effective and has the potential to change the clinical outcome of patients. Therefore, ICG should be routinely used in gastrointestinal cancers to improve the surgical outcomes of patients. In addition, this review summarizes the ICG administration in the literature, and we expect future guidelines to unitize and standardize the administration of ICG.

P226 Indocyanine green fluorescence imaging for real-time detection of breast cancer tumors: a systematic review

P226 Indocyanine green fluorescence imaging for real-time detection of breast cancer tumors: a systematic review

Unsettling Arts of Extinction in Henrietta Rose-Innes' Green Lion

Henrietta Rose-Innes' novel Green Lion illuminates how art participates in human-animal relationships and impacts the lives and deaths of animals. As it narrates the demise of the Cape lion, the novel reveals the continuing influence of settler-capitalist ideologies and practices of preservation on representations of and responses to lions. This essay explores Rose-Innes' turn to taxidermy as inspiration for both the form and content of her novel, arguing that she crafts a work that resonates with new taxidermy in visual arts as she deploys narrative strategies that expose the consequences of images that neglect nonhuman life worlds and conceal death to offer consoling illusions of perpetual presence. Rather than recovering stories of lost animal worlds, Green Lion repositions animal images within histories of multispecies entanglements, exemplifying how literary texts can reframe animal lives and deaths to confront feelings of grief and guilt and reckon with legacies of settler-capitalism that have been obscured by images of timeless nature.

Does Green Image Influence Student Loyalty: A Conceptual Framework

As the application of green image to predict student loyalty is still limited in the literature, this study's primary purpose is to propose a conceptual framework to examine student loyalty in higher education using green image as an antecedent in addition to service quality, HEI image, HEI reputation and student satisfaction. The proposed conceptual framework is predicated primarily on a review of prior research employing green image to predict customer loyalty in non-higher education contexts and prediction of student loyalty in higher education contexts. This study identifies the fundamental concepts that may serve as antecedents of student loyalty in higher education. In addition to service quality, HEI image, HEI reputation and student satisfaction, a conceptual framework has been proposed to discuss the impact of green image on student loyalty in higher education. This study is restricted to the proposing of a conceptual framework as no empirical evidence is presented. Nevertheless, the proposed conceptual framework in this study could facilitate the theoretical and managerial implications for enhancing student loyalty in higher education. The novel aspect of this study is the incorporation of the concept of green image in predicting student loyalty in higher education. Existing research uses the common HEI image and not the green image to predict student loyalty. Based on the gaps in the literature, a conceptual framework is proposed, which could serve as the basis for future research.