[Application of indocyanine green-fluorescent imaging technique in planning resection line and real-time surgical navigation in small hepatocellular carcinoma]

Zhonghua Wai Ke Za Zhi. 2016 Jun 1;54(6):444-450. doi: 10.3760/cma.j.issn.0529-5815.2016.06.011.
[Article in Chinese]

Abstract

Objective: To explore the value of near-infrared technology guided by indolecyanine green(ICG) in planning resection line and real-time surgical navigation in small liver cancer. Methods: From March to September 2015, 11 patients with hepatic tumors received hepatectomy were treated in First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University.There were 5 male and 6 female patients with average age of (55±10)years (range 39-70 years). Among whom, there were 9 cases with hepatocellular carcinoma and 2 cases with colorectal cancer. A near-infrared light camera system was used to detect the liver surfaces before resection, and to plan resection line and surgical specimens. A student's t test was used to compare continuous parametric variables. Results: The ICG-fluorescent imaging and histological examination had been used in the 15 lesions of the 11 patients. Among the 15 lesions, 7 lesions were detected by visual inspections, palpation and ICG-fluorescent imaging, 6 lesions were identified only by ICG-fluorescent imaging, 2 lesions were detected only by ICG-fluorescent imaging after resection.Results of pathologic examination indicated that the total fluorescent type include 5 well differentiated hepatocellular carcinoma and 2 cirrhotic nodule; the partial fluorescent type include 3 moderately differentiated hepatocellular carcinomas and 1 well differentiated hepatocellular carcinomas; the rim fluorescent type included 2 liver metastatic carcinoma and 2 poorly differentiated hepatocellular carcinomas. The average diameter of the tumor size measured by CT was (1.7±0.2)cm, while the average diameter measured by ICG-fluorescent imaging was (1.7±0.3)cm(t=-0.188, P>0.05). Conclusion: Near-infrared technology guided by ICG has important value in planning resection line and real-time surgical navigation in small liver cancer.

MeSH terms

  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / surgery
  • Coloring Agents
  • Diagnostic Imaging / methods*
  • Female
  • Fluorescent Dyes*
  • Hepatectomy / methods*
  • Humans
  • Indocyanine Green*
  • Infrared Rays*
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / surgery
  • Male
  • Operative Time
  • Surgery, Computer-Assisted / methods*

Substances

  • Coloring Agents
  • Fluorescent Dyes
  • Indocyanine Green