Use Of Indocyanine Green Research Articles

A Self-Assembly ICG Nanoparticle Potentiating Targeted Photothermal and Photodynamic Therapy in NSCLC.

In nonsmall cell lung cancers (NSCLC), near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has proven to be an efficient approach for locating pulmonary nodules and pulmonary sentinel lymph nodes. However, due to a lack of tumor selectivity, ICG's use as a photosensitizer for photothermal therapy (PTT) and photodynamic therapy (PDT) is restricted. In the current study, we aimed to develop a type of high-performance NIR nanoparticle formulated with ICG to enhance its targeted efficacy and tumor specificity on NSCLC. An ICG-osimertinib nanoparticle (ICG-Osi) was self-assembled through π-π stacking, with a size of 276 nm and a surface charge of -7.4 mV. The NIR visibility and epidermal growth factor receptor (EGFR) targetability of the ICG-Osi was confirmed by its binding efficiency to EGFR-expressing NSCLC cells in vitro and in vivo, regardless of EGFR mutation status. The targeted effect was further confirmed in mouse xenograft models and showed an extended tumor retention time (>96 h). We demonstrated a significantly enhanced hyperthermia effect and a retained reactive oxygen species (ROS) generating ability of ICG-Osi, resulting in a 2-fold higher cell death rate than ICG alone. The ICG-Osi down-regulated GPX4 and p62 expression while up-regulating caspase-3 and beclin1 expression in NSCLC cells, indicating a complex network of cell death-related proteins. Considering the merits of simple assembly, EGFR binding efficacy, improved hyperthermia effect, and efficient cancer cell suppression, the ICG-Osi exhibits great potential for clinical application in EGFR-expressing NSCLC therapy.

Characterization of Near-Infrared Imaging and Indocyanine-Green Use Amongst General Surgeons: A Survey of 263 General Surgeons

BackgroundNear-infrared fluorescence imaging (NIRFI) is an increasingly utilized imaging modality, however its use amongst general surgeons and its barriers to adoption have not yet been characterized.MethodsThis survey was sent to Canadian Association of General Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons members. Survey development occurred through consensus of NIRFI experienced surgeons.ResultsSurvey completion rate for those opening the email was 16.0% (n = 263). Most respondents had used NIRFI (n = 161, 61.2%). Training, higher volumes, and bariatric, thoracic, or foregut subspecialty were associated with use (P < .001).Common reasons for NIRFI included anastomotic assessment (n = 117, 72.7%), cholangiography (n = 106, 65.8%), macroscopic angiography (n = 66, 41.0%), and bowel viability assessment (n = 101, 62.7%). Technical knowledge, training and poor evidence were cited as common barriers to NIRFI adoption.ConclusionsNIRFI use is common with high case volume, bariatric, foregut, and thoracic surgery practices associated with adoption. Barriers to use appear to be lack of awareness, low confidence in current evidence, and inadequate training. High quality randomized studies evaluating NIRFI are needed to improve confidence in current evidence; if deemed beneficial, training will be imperative for NIRFI adoption.

Real-time assessment of intestinal viability using indocyanine green fluorescent imaging (with video)

Indocyanineuorescent imaging;Intestinal viability;Intraoperativeischemia assessmentOne of the major concerns in colorectal surgery is to assess the viability of a colorectalanastomosis in situ, because poor vascularization is considered to be a risk factor foranastomotic leakage. For some groups, any intraoperative doubts about intestinal viabilitymust be followed by a ‘‘second look’’ at 24 or 48hours because there are no consensualmethod (i.e., clinical, biological, or morphological) to assess the vascular supply of thedigestive tube. Imaging detection based on the uorescence properties of indocyaninegreen has been recently developed in liver surgery for the identication of the bile ductsand livercancersduringsurgery[1].Thistechniquealsoallowsvisualizingvesselswithintheintestine and the surrounding tissues [2]. It has been recently validated in animal modelsof intestinal ischemia [3]. Here, in this video vignette, we detail the use of indocyaninegreen (ICG) uorescent imaging to intraoperatively evaluate the intestinal perfusion andviability during bowel surgery.A 66-year-old woman, without any past medical history, was admitted to our hos-pital with episodes of abdominal pain. The physical examination revealed severe anddiffuse abdominal tenderness and muscle guarding. Computed tomography showed mod-erate ascites and several dilated intestinal loops. The diagnosis of small bowel ischemiawas considered, and an immediate laparotomy was performed. The laparotomy ndingsshowed a massive small intestinal necrosis.Intraoperatively, 12.5mg (5mL) of ICG (Infracyanine, Laboratoire Serb, Paris, France)was injected into a peripheral vein. The device (Photo Dynamic Eye PDE: HamamatsuPhotonics Co) was used for intraoperative uorescent images of small bowel. Beforesmall bowel resection, the uorescent imaging clearly delineated the necrotic regionsof the small bowel. After resection, the serosal surface color of distal part of the resid-ual ileum showed a slightly darker hue than the proximal part of the residual jejunum.