Interhospital variability in localization techniques for small pulmonary nodules in children: A pediatric surgical oncology research collaborative study

Morgan, Katrina M.; Anderson, Kathryn T.; Johnston, Michael E.; Dasgupta, Roshni; Crowley, John; Fahy, Aodhnait S.; Lapidus-Krol, Eveline; Baertschiger, Reto M.; Lautz, Timothy B.; Many, Benjamin T.; Marquart, John; Gainer, Haley; Lal, Dave R.; Rich, Barrie S.; Glick, Richard D.; MacArthur, Taleen A.; Polites, Stephanie F.; Kastenberg, Zachary J.; Short, Scott S.; Meyers, Rebecka L.; Talbot, Lindsay J.; Abdelhafeez, Abdelhafeez; Prajapati, Hasmukh J.; Davidoff, Andrew M.; Rubaclava, Nathan; Newman, Erika A.; Ehrlich, Peter F.; Rothstein, David H.; Roach, Jonathan P.; Ladd, Patricia; Janek, Kevin C.; Le, Hau D.; Leraas, Harold J.; Tracy, Elisabeth T.; Bisset, Logan; Mora, María; Warren, Patrick; Aldrink, Jennifer H.; Malek, Marcus M.

doi:10.1016/j.jpedsurg.2022.01.061

Cited by 5 publications

(8 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Those studies reported increased ICG uptake and impaired excretion of the fluorophore due to the tumor's biliary characteristics. 2,[22][23][24][25][26][27][28][29] However, the literature lacks information about nonhepatic tumor-related metastases and the feasibility and effectiveness of ICG application in those cases.…”

Section: Discussionmentioning

confidence: 99%

“…However, these approaches require transferring anesthetized patients from the interventional radiology (IR) suite to the operating room. 2 Moreover, IR localization is associated with the risks of positioning inaccuracy, migration of the localizer, pneumothorax, and pain. [2][3][4][5][6][7][8] Indocyanine green (ICG) is a water-soluble tricarbocyanine fluorophore that has an excellent safety profile and is approved by the U.S.…”

Section: Introductionmentioning

confidence: 99%

“…Localization techniques for pulmonary nodules include computed tomography (CT)‐guided placement of a localizer (e.g., a hook, wire, or coil). However, these approaches require transferring anesthetized patients from the interventional radiology (IR) suite to the operating room 2 . Moreover, IR localization is associated with the risks of positioning inaccuracy, migration of the localizer, pneumothorax, and pain 2–8 …”

Section: Introductionmentioning

confidence: 99%

“…However, these approaches require transferring anesthetized patients from the interventional radiology (IR) suite to the operating room 2 . Moreover, IR localization is associated with the risks of positioning inaccuracy, migration of the localizer, pneumothorax, and pain 2–8 …”

Section: Introductionmentioning

confidence: 99%

“…Preclinical trials and adult clinical trials have shown that second‐window imaging improves the precision of ICG‐guided localization of pulmonary nodules 12–21 . More recently, pediatric studies have demonstrated promising sensitivity and specificity of this technique for localizing hepatoblastoma pulmonary metastases 2,22–29 . However, little is known about the feasibility of ICG‐guided localization of other metastatic solid tumors.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Feasibility of indocyanine green‐guided localization of pulmonary nodules in children with solid tumors

Abdelhafeez

Mothi

Pio

et al. 2023

Pediatric Blood & Cancer

Self Cite

View full text Add to dashboard Cite

BackgroundClearing all pulmonary metastases is essential for curing pediatric solid tumors. However, intraoperative localization of such pulmonary nodules can be challenging. Therefore, an intraoperative tool that localizes pulmonary metastases is needed to improve diagnostic and therapeutic resections. Indocyanine green (ICG) real‐time fluorescence imaging is used for this purpose in adult solid tumors, but its utility in pediatric solid tumors has not been determined.MethodsA single‐center, open‐label, nonrandomized, prospective clinical trial (NCT04084067) was conducted to assess the ability of ICG to localize pulmonary metastases of pediatric solid tumors. Patients with pulmonary lesions who required resection, either for therapeutic or diagnostic intent, were included. Patients received a 15‐minute intravenous infusion of ICG (1.5 mg/kg), and pulmonary metastasectomy was performed the following day. A near‐infrared spectroscopy iridium system was optimized to detect ICG, and all procedures were photo‐documented and recorded.ResultsICG‐guided pulmonary metastasectomies were performed in 12 patients (median age: 10.5 years). A total of 79 nodules were visualized, 13 of which were not detected by preoperative imaging. Histologic examination confirmed the following histologies: hepatoblastoma (n = 3), osteosarcoma (n = 2), and one each of rhabdomyosarcoma, Ewing sarcoma, inflammatory myofibroblastic tumor, atypical cartilaginous tumor, neuroblastoma, adrenocortical carcinoma, and papillary thyroid carcinoma. ICG guidance failed to localize pulmonary metastases in five (42%) patients who had inflammatory myofibroblastic tumor, atypical cartilaginous tumor, neuroblastoma, adrenocortical carcinoma, or papillary thyroid carcinoma.ConclusionsICG‐guided identification of pulmonary nodules is not feasible for all pediatric solid tumors. However, it may localize most metastatic hepatic tumors and high‐grade sarcomas in children.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Feasibility of indocyanine green‐guided localization of pulmonary nodules in children with solid tumors

Abdelhafeez

Mothi

Pio

et al. 2023

Pediatric Blood & Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

Management of undifferentiated embryonal sarcoma of the liver: A Pediatric Surgical Oncology Research Collaborative study

Kastenberg,

Short,

Riehle

et al. 2024

Pediatric Blood & Cancer

Self Cite

View full text Add to dashboard Cite

BackgroundUndifferentiated embryonal sarcoma of the liver (UESL) is a rare tumor for which there are few evidence‐based guidelines. The aim of this study was to define current management strategies and outcomes for these patients using a multi‐institutional dataset curated by the Pediatric Surgical Oncology Research Collaborative.MethodsData were collected retrospectively for patients with UESL treated across 17 children's hospitals in North America from 1989 to 2019. Factors analyzed included patient and tumor characteristics, PRETEXT group, operative details, and neoadjuvant/adjuvant regimens. Event‐free and overall survival (EFS, OS) were the primary and secondary outcomes, respectively.ResultsSeventy‐eight patients were identified with a median age of 9.9 years [interquartile range [IQR): 7–12]. Twenty‐seven patients underwent resection at diagnosis, and 47 patients underwent delayed resection, including eight liver transplants. Neoadjuvant chemotherapy led to a median change in maximum tumor diameter of 1.6 cm [IQR: 0.0–4.4] and greater than 90% tumor necrosis in 79% of the patients undergoing delayed resection. R0 resections were accomplished in 63 patients (81%). Univariate analysis found that metastatic disease impacted OS, and completeness of resection impacted both EFS and OS, while multivariate analysis revealed that R0 resection was associated with decreased expected hazards of experiencing an event [hazard ratio (HR): 0.14, 95% confidence interval (CI): 0.04–0.6]. At a median follow‐up of 4 years [IQR: 2–8], the EFS was 70.0% [95% CI: 60%–82%] and OS was 83% [95% CI: 75%–93%].ConclusionComplete resection is associated with improved survival for patients with UESL. Neoadjuvant chemotherapy causes minimal radiographic response, but significant tumor necrosis.

show abstract

Advocating for the surgical needs of children with cancer

Davidoff

2022

Journal of Pediatric Surgery

View full text Add to dashboard Cite

Interhospital variability in localization techniques for small pulmonary nodules in children: A pediatric surgical oncology research collaborative study

Cited by 5 publications

References 15 publications

Feasibility of indocyanine green‐guided localization of pulmonary nodules in children with solid tumors

Feasibility of indocyanine green‐guided localization of pulmonary nodules in children with solid tumors

Management of undifferentiated embryonal sarcoma of the liver: A Pediatric Surgical Oncology Research Collaborative study

Advocating for the surgical needs of children with cancer

Contact Info

Product

Resources

About