Skull bone tumor resection with intraoperative indocyanine green fluorescence imaging: A series of four surgical cases

Asayama, Bunsho; Sato, Kenichi; Fukui, Takahito; Okuma, Masahiro; Nakagaki, Yusuke; Nakagaki, Youichi; Osato, Toshiaki; Nakamura, Hirohiko

doi:10.1016/j.inat.2017.02.003

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Pediatric neurosurgeons used ICG-FA in patients with Moyamoya disease to evaluate the anatomy and confirm patency of their surgical anastomoses ( n = 4) ( 9 , 35 , 36 , 62 ). Tumor detection ( n = 3) ( 10 , 43 , 66 ), arteriovenous malformations ( n = 2) ( 63 , 67 ), cerebral mycotic aneurysm ( n = 1) ( 73 ), and intracranial pial arteriovenous fistula ( n = 1) ( 60 ) were other neurosurgical indications. In pediatric cardiac surgery, ICG-FA was used for congenital cardiac surgeries ( n = 3) ( 45 , 52 , 68 ) and post-operative chylothorax ( n = 2) ( 40 , 61 ).…”

Section: Resultsmentioning

confidence: 99%

The Use of Indocyanine Green Fluorescence Angiography in Pediatric Surgery: A Systematic Review and Narrative Analysis

et al. 2021

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Purpose: Indocyanine green fluorescence angiography (ICG-FA) is a validated non-invasive imaging technique used to assess tissue vascularization and guide intraoperative decisions in many surgical fields including plastic surgery, neurosurgery, and general surgery. While this technology is well-established in adult surgery, it remains sparsely used in pediatric surgery. Our aim was to systematically review and provide an overview of all available evidence on the perioperative use of indocyanine green fluorescence angiography in pediatric surgical patients.Methods: We conducted a systematic review with narrative synthesis in conformity with the PRISMA guidelines using PubMed, Medline, All EBM Reviews, EMBASE, PsycINFO, and CINAHL COMPLETE databases to identify articles describing the perioperative use of ICG-FA in pediatric patients. Two independent authors screened all included articles for eligibility and inclusion criteria. We extracted data on study design, demographics, surgical indications, indocyanine green dose, and perioperative outcomes. We developed a risk of bias assessment tool to evaluate the methodological quality of included studies.Results: Of 1,031 articles retrieved, a total of 64 articles published between 2003 and 2020 were included reporting on 664 pediatric patients. Most articles were case reports and case series (n = 36; 56%). No adverse events related to ICG-FA were reported in the included articles. Risk of bias was high. We did not conduct a meta-analysis given the heterogeneous nature of the populations, interventions, and outcome measures. A narrative synthesis is presented.Conclusion: Indocyanine green fluorescence angiography is a safe imaging technology and its use is increasing rapidly in pediatric surgical specialties. However, the quality of evidence supporting this trend currently appears low. Case-control and randomized trials are needed to determine the adequate pediatric dose and to confirm the potential benefits of ICG-FA in pediatric surgical patients.Systematic Review Registration: This study was registered on Prospero a priori, identifier: CRD42020151981.

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Section: Resultsmentioning

confidence: 99%

The Use of Indocyanine Green Fluorescence Angiography in Pediatric Surgery: A Systematic Review and Narrative Analysis

et al. 2021

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“…ndocyanIne green (ICG) has been used for decades in vascular neurosurgery since its introduction by Raabe et al 1 Several studies have described the benefits of using microscope-integrated ICG in various spinal and cranial tumors. [2][3][4][5][6] Recent studies have suggested the administration of high doses of ICG the day before surgery to take advantage of the fluorescence induced in meningiomas, gliomas, and brain metastases. [7][8][9] Endoscope-integrated ICG (E-ICG) has been used in visualizing vascular structures [10][11][12][13] and performing biopsy of intraventricular tumors.…”

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confidence: 99%

The role of indocyanine green fluorescence in endoscopic endonasal skull base surgery and its imaging correlations

Shahein¹,

Prevedello

Beaumont³

et al. 2021

Journal of Neurosurgery

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OBJECTIVEThe use of endoscope-integrated indocyanine green (E-ICG) has recently been introduced in skull base surgery. The quantitative correlation between E-ICG and T1-weighted gadolinium-enhanced (T1WGd) images for skull base tumors has not been previously assessed, to the authors’ knowledge. In this study, the authors investigated the indications for use and the limitations of E-ICG and sought to correlate the endoscopic fluorescence pattern with MRI contrast enhancement.METHODSFollowing IRB approval, 20 patients undergoing endoscopic endonasal skull base surgery between June 2017 and August 2018 were enrolled in the study. Tumor fluorescence was measured using a blue color value and blood fluorescence as a control. Signal intensities (SIs) of tumor T1WGd images were measured and the internal carotid artery (ICA) SI was used as a control. For pituitary adenoma, the pituitary gland fluorescence was also measured. The relationships between ICG fluorescence and MRI enhancement measurements were analyzed.RESULTSData showed that in pituitary adenoma there was a strong correlation between the ratios of gland/blood fluorescence to gland/ICA SI (n = 8; r = 0.92; p = 0.001) and tumor/blood fluorescence to tumor/ICA SI (n = 9; r = 0.82; p = 0.006). In other pathologies there was a strong correlation between the ratios of tumor/blood fluorescence and tumor/ICA SI (n = 9; r = 0.74; p = 0.022). The ICG fluorescence allowed perfusion assessment of the pituitary gland as well as of the nasoseptal flaps. Visualization of the surrounding vasculature was also feasible.CONCLUSIONSDefining the indications and understanding the limitations are critical for the effective use of E-ICG. Tumor fluorescence seems to correlate with preoperative MRI contrast enhancement.

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Clinical Consensus Statement on the Use of Indocyanine Green Fluorescence-guided Surgery in Pediatric Patients

Szavay,

Bondoc,

Esposito

et al. 2024

Journal of Pediatric Surgery

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Skull bone tumor resection with intraoperative indocyanine green fluorescence imaging: A series of four surgical cases

Cited by 3 publications

References 15 publications

The Use of Indocyanine Green Fluorescence Angiography in Pediatric Surgery: A Systematic Review and Narrative Analysis

The Use of Indocyanine Green Fluorescence Angiography in Pediatric Surgery: A Systematic Review and Narrative Analysis

The role of indocyanine green fluorescence in endoscopic endonasal skull base surgery and its imaging correlations

Clinical Consensus Statement on the Use of Indocyanine Green Fluorescence-guided Surgery in Pediatric Patients

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