Fluorescence-Guided Surgery for Hepatoblastoma with Indocyanine Green

Yamada, Yasuaki; Ohno, Michinobu; Fujino, Akihiro; Kanamori, Yutaka; Irie, Rie; Yoshioka, Takako; Miyazaki, Osamu; Uchida, Hajime; Fukuda, Akira; Sakamoto, Seisuke; Kasahara, Mureo; Matsumoto, Kimikazu; Fuchimoto, Yasushi; Hoshino, Ken; Kuroda, Takeshi; Hishiki, Tomoro

doi:10.3390/cancers11081215

Cited by 62 publications

(70 citation statements)

References 44 publications

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“…ICG is often used as an organ function test agent such as for blood volume determination, cardiac output, and hepatic function; however, it is rapidly excreted from the body via the liver and kidney and is very difficult to achieve its accumulation in the diseased region 48 - 49 . After mice bearing MDA-MB-231 tumors were injected with P60-ICG-THP, fluorescence live images were acquired at different time points (Figure 7 A).…”

Section: Resultsmentioning

confidence: 99%

In situ tumor-triggered subcellular precise delivery of multi-drugs for enhanced chemo-photothermal-starvation combination antitumor therapy

et al. 2020

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Rationale: Drug combination therapy for cancer treatment exerts a more potent antitumor effect. The targeted delivery and release of multiple drugs in a patient's body thus presents a more effective treatment approach, warranting further research. Methods: Two antitumor drugs (ICG: indocyanine green and THP: pirarubicin) were successfully screened to sequentially trigger self-assembling peptides (P60) to produce bacteria-sized particles (500-1000 nm, P60-ICG-THP). First, after mixing equal amount of P60 and ICG, trace amount of water (the mass ratio between P60 and water: 100:1) was used to trigger their assembly into P60-ICG. Subsequently, the assembly of P60-ICG and THP was further triggered by ultrasound treatment to produce P60-ICG-THP. Results: P60-ICG-THP constituted a cluster of several nanoparticles (50-100 nm) and possessed a negative charge. Owing to its size and charge characteristics, P60-ICG-THP could remain outside the cell membrane, avoiding the phagocytic clearance of blood and normal tissue cells in vivo . However, after localizing in the tumor, the size and charge switches of P60-ICG-THP, rapidly triggered by the low pH of the tumor microenvironment, caused P60-ICG-THP to segregate into two parts: (i) positively charged nanoparticles with a size of approximately 50 nm, and (ii) negatively charged particles of an uneven size. The former, mainly carrying THP (chemotherapeutic agent), could immediately cross the cell membrane and deliver pirarubicin into the nucleus of tumor cells. The latter, carrying ICG (used for photothermal therapy), could also enter the cell via the endocytosis pathway or accumulate in tumor blood vessels to selectively block the supply of nutrients and oxygen (cancer starvation). Both these particles could avoid the rapid excretion of ICG in the liver and were conducive to accumulation in the tumor tissue for photothermal therapy. Conclusion: Our drug delivery system not only achieves the precise subcellular delivery of two anticancer drugs due to their size and charge switches in the tumor site, but also provides a new strategy to combine chemotherapy, photothermal therapy, and cancer starvation therapy for the development of a highly efficient antitumor therapeutic regimen.

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Section: Resultsmentioning

confidence: 99%

In situ tumor-triggered subcellular precise delivery of multi-drugs for enhanced chemo-photothermal-starvation combination antitumor therapy

et al. 2020

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“…Thus, light emitting diode could play a significant role in development of novel biomedical optical devices, since it avoids multiple excitation filters used for blocking unnecessary spectra and possesses high luminous efficacy, lower cost and energy expenditure [20]. PDE-NEO II represents one of such devices where LED is employed for intraoperative angiography and could satisfy the expectations of clinic in several applications including lymphography [21], hepatoblastoma [22] and supraclavicular flaps [23]. Yamamoto et al also used a Hyper-Eye medical system (HEMS) based on NIR LED light for assessment of CABG procedure [24].…”

Section: Discussionmentioning

confidence: 99%

A novel fluorescent cardiac imaging system for preclinical intraoperative angiography

2021

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Background Intraoperative coronary angiography can tremendously reduce early coronary bypass graft failures. Fluorescent cardiac imaging provides an advanced method for intraoperative observation and real-time quantitation of blood flow with high resolution. Methods We devised a system comprised of an LED light source, special filters, lenses and a detector for preclinical coronary artery angiography. The optical setup was implemented by using two achromatic doublet lenses, two positive meniscus lenses, a band-pass filter, a pinhole and a CCD sensor. The setup was optimized by Zemax software. Optical design was further challenged to obtain more parallel light beams, less diffusion and higher resolutions to levels as small as arterioles. Ex vivo rat hearts were prepared and coronary arteries were retrogradely perfused by indocyanine green (ICG). Video angiography was employed to assess blood flow and plot time-dependent fluorescence intensity curve (TIC). Quantitation of blood flow was performed by calculating either the gradient of TIC or area under curve. The correlation between blood flow and each calculated parameters was assessed and used to evaluate the quality of flow. Results High-resolution images of flow in coronary arteries were obtained as precise as 62 µm vessel diameter, by our custom-made ICG angiography system. The gradient of TIC was 3.4–6.3 s−1, while the area under curve indicated 712–1282 s values which ultimately gained correlation coefficients of 0.9938 and 0.9951 with relative blood flow, respectively. Conclusion The present ICG angiography system may facilitate evaluation of blood flow in animal studies of myocardial infarction and coronary artery grafts intraoperatively.

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“…We hypothesized that this imaging method could help treat HB as in HCC. Yamada et al and Yamamichi et al applied surgical navigation using ICG fluorescence imaging to detect HB lesions and demonstrated its usefulness in the complete resection of HB (7,8). Other authors have reported similar results.…”

Section: Introductionmentioning

confidence: 87%

The Advantages of Indocyanine Green Fluorescence Imaging in Detecting and Treating Pediatric Hepatoblastoma: A Preliminary Experience

et al. 2021

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Background: Currently, indocyanine green (ICG) fluorescence imaging enables radical surgical resection in hepatoblastoma (HB) and has beneficial uses; however, its usage in pediatric patients is still limited.Methods: From 2015 to 2019, 17 hepatoblastoma patients underwent 22 fluorescence-guided surgery using ICG. ICG (0.3 mg/kg) was intravenously injected 24–48 h before the operation. With ICG/NIR camera, intraoperative identification of biological structures and demarcation of mass were conducted.Results: ICG fluorescence-guided surgery was performed for hepatoblastoma in 22 cases: 16, 1, and 2 cases underwent anatomic resection, partial hepatectomy, and liver transplantation, respectively. Six patients accompanied lung metastasis at the time of surgery, and two patients underwent lung surgery using ICG. The median interval from ICG injection to surgery was 38.3 h (range, 20.5–50.3 h). The median tumor size was 36.5 mm (range, 2–132 mm). According to the pathologic finding, the median safety margin was secured for 6 mm (range, 0–11 mm) and there was no residual finding at the liver at the follow-up computed tomography (CT).Conclusions: ICG fluorescence imaging in children with HB was feasible and safe for tumor demarcation and enhancing the accuracy of radical tumor resection.

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Fluorescence-Guided Surgery for Hepatoblastoma with Indocyanine Green

Cited by 62 publications

References 44 publications

In situ tumor-triggered subcellular precise delivery of multi-drugs for enhanced chemo-photothermal-starvation combination antitumor therapy

In situ tumor-triggered subcellular precise delivery of multi-drugs for enhanced chemo-photothermal-starvation combination antitumor therapy

A novel fluorescent cardiac imaging system for preclinical intraoperative angiography

The Advantages of Indocyanine Green Fluorescence Imaging in Detecting and Treating Pediatric Hepatoblastoma: A Preliminary Experience

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