Fluorescence‐guided surgery using indocyanine green in dogs with superficial solid tumours

Abstract

BackgroundNear-infrared fluorescence (NIRF) imaging is a relatively novel technique that can aid surgeons during intraoperative tumour identification.MethodsNine canine oncology patients (five mammary gland tumours, three mast cell tumours and one melanoma) received intravenous indocyanine green (ICG). After 24 hours, tumours were resected and fluorescence intensities of tumours and surroundings were evaluated. Additional wound bed tissue was resected if residual fluorescence was present after tumour resection. Ex vivo, fluorescence-guided dissection was performed to separate tumour from surrounding tissue.ResultsIntraoperative NIRF-guided tumour delineation was feasible in four out of nine dogs. Wound bed imaging after tumour removal identified nine additional fluorescent lesions, of which four contained tumour tissue. One of these four true positive in vivo lesions was missed by standard-of-care inspection. Ex vivo fluorescence-guided tumour dissection showed a sensitivity of 72 per cent and a specificity of 80 per cent in discriminating between tumour and surrounding tissue.ConclusionThe value of ICG for intraoperative tumour delineation seems more limited than originally thought. Although NIRF imaging using ICG did identify remaining tumour tissue in the wound bed, a high false positive rate was also observed.

Case Report: Indocyanine Green-Based Angiography for Real-Time Assessment of Superficial Brachialis Axial Pattern Flap Vascularization in Two Dogs

“…Intravenous injection of ICG has been previously determined to be safe for dogs ( 14 , 15 ). Our findings underline this, as no adverse effects were noticed in conjunction with the injection (including no alterations in heart rate or blood pressure).…”

B-Mode and Contrast-Enhanced Ultrasonography Aspects of Benign and Malignant Superficial Neoplasms in Dogs: A Preliminary Study

“…Written informed consent was obtained from all patient owners before entry into the original study. The data have in part been used in previous publications (Cicchelero et al, 2017 [ 24 ], Cicchelero et al, 2017 [ 25 ], Abma et al, 2018 [ 18 ], Favril et al, 2020a [ 26 ] and Favril et al, 2020b [ 27 ]). Dogs were eligible for the original studies when the neoplasm was accessible with a linear ultrasound probe and the origin of the neoplasm was confirmed by histopathology.…”

“…Histopathological evaluation of the resected neoplasms was performed as described by Cicchelero et al, 2017 [ 24 ], Cicchelero et al, 2017 [ 25 ], Abma et al, 2018 [ 18 ], Favril et al, 2020a [ 26 ] and Favril et al, 2020b [ 27 ]. The histological assessment was conducted by a board-certified veterinary pathologist.…”

Performance of two clinical fluorescence imaging systems with different targeted and non-targeted near-infrared fluorophores: a cadaveric explorative study

“…The use of fluorescence-guided surgery (FGS) in both veterinary and human surgery has received growing interest in recent years (1)(2)(3)(4). While traditional surgery relies on surgeons' subjective visual and tactile cues to identify target tissue intraoperatively, FGS uses a fluorescent signal to guide the surgical dissection toward the target tissue, potentially improving the sensitivity of conventional surgical techniques (1,2,5).…”