Optimization of Second Window Indocyanine Green for Intraoperative Near-Infrared Imaging of Thoracic Malignancy

被引:45
|
作者
Newton, Andrew D. [1 ]
Predina, Jarrod D. [1 ]
Corbett, Christopher J. [1 ]
Frenzel-Sulyok, Lydia G. [1 ]
Xia, Leilei [1 ]
Petersson, E. James [3 ]
Tsourkas, Andrew [4 ]
Nie, Shuming [5 ]
Delikatny, Edward J. [2 ]
Singhal, Sunil [1 ]
机构
[1] Univ Penn, Sch Med, Dept Surg, Philadelphia, PA 19104 USA
[2] Univ Penn, Sch Med, Dept Radiol, Philadelphia, PA 19104 USA
[3] Univ Penn, Dept Chem, Philadelphia, PA 19104 USA
[4] Univ Penn, Dept Bioengn, Philadelphia, PA 19104 USA
[5] Univ Illinois, Dept Bioengn, Urbana, IL USA
关键词
ENHANCED PERMEABILITY; TUMORS; IDENTIFICATION;
D O I
10.1016/j.jamcollsurg.2018.11.003
中图分类号
R61 [外科手术学];
学科分类号
摘要
BACKGROUND: Near-infrared (NIR) imaging using the second time window of indocyanine green (ICG) allows localization of pulmonary, pleural, and mediastinal malignancies during surgery. Based on empirical evidence, we hypothesized that different histologic tumor types fluoresce optimally at different ICG doses. STUDY DESIGN: Patients with thoracic tumors biopsy-proven or suspicious for malignancy were enrolled in an NIR imaging clinical trial. Patients received a range of ICG doses 1 day before surgery: 1 mg/kg (n = 8), 2 mg/kg (n = 8), 3 mg/kg (n = 13), 4 mg/kg (n = 8), and 5 mg/kg (n = 8). Intraoperatively, NIR imaging was performed. The endpoint was to identify the highest tumor-to-background fluorescence ratio (TBR) for each tumor type at each dose. Final pathology confirmed tumor histology. RESULTS: Of 45 patients, 41 had malignancies (18 non-small cell lung cancers [NSCLC], 3 pulmonary neuroendocrine tumors, 13 thoracic metastases, 4 thymomas, 3 mesotheliomas). At doses of 4 to 5 mg/kg, the TBR from primary NSCLC vs other malignancies was no different (2.70 vs 3.21, p = 1.00). At doses of 1 to 3 mg/kg, the TBR was greater for the NSCLCs (3.19 vs 1.49, p = 0.0006). Background fluorescence from the heart or ribs was observed in 1 of 16 cases at 1 to 2 mg/kg, 5 of 13 cases at 3 mg/kg, and 14 of 16 cases at 4 to 5 mg/kg; this was a major determinant of dose optimization. CONCLUSIONS: This is the first study to demonstrate that the optimal NIR contrast agent dose varies by tumor histology. Lower dose ICG (2 to 3 mg/kg) is superior for nonprimary lung cancers, and high dose ICG (4 to 5 mg/kg) is superior for lung cancers. This will have major implications as more intraoperative imaging trials surface in other specialties, will significantly reduce costs and may facilitate wider application. (C) 2018 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:188 / 197
页数:10
相关论文
共 50 条
  • [1] Intraoperative Near-Infrared Imaging with Second Window Indocyanine Green for Pancreatic Adenocarcinoma
    Newton, Andrew D.
    Predina, Jarrod
    Mizelle, Jack
    Connolly, Courtney
    Dunbar, Ashley
    Baldassari, Michael
    Drebin, Jeffrey A.
    Singhal, Sunil
    Lee, Major K., IV
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2017, 225 (04) : S193 - S193
  • [2] Intraoperative Near Infrared Imaging with Second Window Indocyanine Green for Thoracic Malignancies: A Dose De-Escalation Trial
    Newton, Andrew D.
    Predina, Jarrod
    Corbett, Christopher J.
    Xia, Leilei
    Shin, Michael H.
    Sulyok, Lydia G. Frenzel
    Singhal, Sunil
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2018, 227 (04) : S241 - S241
  • [3] Indocyanine green fluorescence in second near-infrared (NIR-II) window
    Starosolski, Zbigniew
    Bhavane, Rohan
    Ghaghada, Ketan B.
    Vasudevan, Sanjeev A.
    Kaay, Alexander
    Annapragada, Ananth
    [J]. PLOS ONE, 2017, 12 (11):
  • [4] Applications of indocyanine green based near-infrared fluorescence imaging in thoracic surgery
    Zhou, Jian
    Yang, Fan
    Jiang, Guanchao
    Wang, Jun
    [J]. JOURNAL OF THORACIC DISEASE, 2016, 8 : S738 - S743
  • [5] Near-Infrared Fluorescence Imaging with Intraoperative Administration of Indocyanine Green for Robotic Partial Nephrectomy
    Marc A. Bjurlin
    Tyler R. McClintock
    Michael D. Stifelman
    [J]. Current Urology Reports, 2015, 16
  • [6] Near-Infrared Fluorescence Imaging with Intraoperative Administration of Indocyanine Green for Robotic Partial Nephrectomy
    Bjurlin, Marc A.
    McClintock, Tyler R.
    Stifelman, Michael D.
    [J]. CURRENT UROLOGY REPORTS, 2015, 16 (04)
  • [7] Intraoperative Near-Infrared Autofluorescence and Indocyanine Green Imaging to Identify Parathyroid Glands: A Comparison
    Lerchenberger, Max
    Al Arabi, Norah
    Gallwas, Julia K. S.
    Stepp, Herbert
    Hallfeldt, Klaus K. J.
    Ladurner, Roland
    [J]. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY, 2019, 2019
  • [8] Novel method of intraoperative liver tumour localisation with indocyanine green and near-infrared imaging
    Lim, Hui Jun
    Chiow, Adrian Kah Heng
    Lee, Lip Seng
    Tan, Siong San
    Goh, Brian Kp
    Koh, Ye Xin
    Chan, Chung Yip
    Lee, Ser Yee
    [J]. SINGAPORE MEDICAL JOURNAL, 2021, 62 (04) : 182 - 189
  • [9] Molecular Imaging in the Second Near-Infrared Window
    Wan, Hao
    Du, Haotian
    Wang, Feifei
    Dai, Hongjie
    [J]. ADVANCED FUNCTIONAL MATERIALS, 2019, 29 (25)
  • [10] Thoracic Duct Lymphography by Near-Infrared Indocyanine Green Fluorescence imaging in Thoracic Surgery. A Review
    Syed Nusrath
    Subramanyeshwar Rao Thammineedi
    Ajesh Raj Saksena
    Sujit Chyau Patnaik
    Pratap Reddy
    Zeeba Usofi
    Santhosh Kumar
    [J]. Indian Journal of Surgical Oncology, 2022, 13 : 415 - 420