Intraoperative ICG-based imaging of liver neoplasms: a simple yet powerful tool. Preliminary results

Abstract

This study is a building block for the characterization of liver nodules and the search for additional surface lesions undetected by preoperative radiological work-up-a crucial task for the successful treatment of liver cancer at an early stage using a safe, minimally invasive, and inexpensive technique.

Indocyanine Green Fluorescence-guided intraoperative detection of peritoneal carcinomatosis: systematic review.

“…From a dosing point of view, virtually all series carry the same dosage (0.25 mg/kg), except one that carries twice and one that uses a xed dose independently from weight (20 mg). All reported injected schedules are similar to that used in other areas for perfusion studies [21].…”

“…It is a low-cost molecule, easy to use, widely available and with negligible toxicity [19]. The use of ICG uorescence in abdominal surgery has been introduced in recent years and represents a common tool for perfusion evaluation, extrahepatic bile duct anatomy, lymph node navigation and liver surgery [20][21][22]. ICG binds primarily to serum albumin and other serum globulins such as alpha1-lipoprotein, and then it circulates behaving like a macromolecule [23].…”

Avoidance of bile duct injury during laparoscopic liver cyst fenestration using indocyanine green: A case report

“…Usually, for visualizing a tumor, ICG is administered 24-48 hours before the surgery. 31 On the other hand, for fluorescent cholangiography, ICG is intravenously administered 0.5-24 hours before the surgery. 32,33 In our experience, intravenous administration of ICG 1 hour before the surgery was sufficient to successfully visualize the small bile duct in the cyst wall, and it also allowed us to avoid accidental bile duct injury.…”

Indocyanine Green Fluorescence-Guided Intraoperative Detection of Peritoneal Carcinomatosis: Systematic Review.

“…ICG binds primarily to serum albumin and other serum globulins such as alpha1-lipoprotein, and then it circulates behaving like a macromolecule [21]. In tumor tissues, such as peritoneal cancer implants, an "enhanced permeability and retention" (EPR) effect has been demonstrated, owing to tumor-induced angiogenesis, different metabolic activity and lack of efficient lymphatic drainage [22,23]. ICG has theorical advantages as a possible contrast agent for macro-and microcirculatory tissue characterization, and consequently for EPR effect: it is uninfluenced by tissue optical properties and has half-life in plasma of few minutes [24,25].…”