TY - JOUR
T1 - Intraoperative fluorescence image-guided pulmonary segmentectomy
AU - Oh, Yujin
AU - Quan, Yu Hua
AU - Kim, Minji
AU - Kim, Beop Min
AU - Kim, Hyun Koo
N1 - Funding Information:
This work was supported by a grant from the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (No: A121074) and by a National Research Foundation of Korea (NRF) grant funded by the Ministry of Education, Science and Technology (No: 2012012166 ).
Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/12
Y1 - 2015/12
N2 - Background The intraoperative color and fluorescence-merged imaging system (ICFIS) is a new technology that may aid the demarcation of intersegmental borders during pulmonary segmentectomy. This study was performed to validate, for the first time, image-guided segmentectomy using ICFIS and to find the optimal dosage of fluorescent dye to ensure safe and sustained imaging during surgery. Methods Nine rabbits were subjected to pulmonary segmentectomy. These constituted three groups of three rabbits each. After ligation of the segmental pulmonary artery supplying the targeted segment, the rabbits were injected intravenously with indocyanine green (ICG) at a concentration of 0.3, 0.6, or 3.0 mg/kg, depending on their group assignment. The optimal dose was determined from the rabbit study and then used to guide ICFIS during pulmonary segmentectomy in five pigs. Results The fluorescent signal contrast ratios of the targeted area to the normal lung using ICG concentrations of 0.3, 0.6, or 3.0 mg/kg were 1.9 ± 0.25, 2.0 ± 0.17, and 2.1 ± 0.06, respectively. The mean ICG washout times were 1, 3, and 6 min, respectively. Proceeding with an ICG concentration of 0.6 mg/kg, the mean washout time was found to be longer in pigs (15 min). This provided adequate time for successful ICFIS-guided segmentectomy in all five pigs, without the requirement for additional procedures for intersegmental plane demarcation. Conclusions ICG image-guided segmentectomy using ICFIS enabled immediate visualization of the intersegmental planes. The washout time using the ICG dose determined in this study was long enough to ensure that visualization was sustained throughout the surgery.
AB - Background The intraoperative color and fluorescence-merged imaging system (ICFIS) is a new technology that may aid the demarcation of intersegmental borders during pulmonary segmentectomy. This study was performed to validate, for the first time, image-guided segmentectomy using ICFIS and to find the optimal dosage of fluorescent dye to ensure safe and sustained imaging during surgery. Methods Nine rabbits were subjected to pulmonary segmentectomy. These constituted three groups of three rabbits each. After ligation of the segmental pulmonary artery supplying the targeted segment, the rabbits were injected intravenously with indocyanine green (ICG) at a concentration of 0.3, 0.6, or 3.0 mg/kg, depending on their group assignment. The optimal dose was determined from the rabbit study and then used to guide ICFIS during pulmonary segmentectomy in five pigs. Results The fluorescent signal contrast ratios of the targeted area to the normal lung using ICG concentrations of 0.3, 0.6, or 3.0 mg/kg were 1.9 ± 0.25, 2.0 ± 0.17, and 2.1 ± 0.06, respectively. The mean ICG washout times were 1, 3, and 6 min, respectively. Proceeding with an ICG concentration of 0.6 mg/kg, the mean washout time was found to be longer in pigs (15 min). This provided adequate time for successful ICFIS-guided segmentectomy in all five pigs, without the requirement for additional procedures for intersegmental plane demarcation. Conclusions ICG image-guided segmentectomy using ICFIS enabled immediate visualization of the intersegmental planes. The washout time using the ICG dose determined in this study was long enough to ensure that visualization was sustained throughout the surgery.
KW - Fluorescence
KW - Image-guided surgery
KW - Indocyanine green
KW - Intraoperative
KW - Pulmonary segmentectomy
UR - http://www.scopus.com/inward/record.url?scp=84947867164&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2015.05.009
DO - 10.1016/j.jss.2015.05.009
M3 - Article
C2 - 26115807
AN - SCOPUS:84947867164
VL - 199
SP - 287
EP - 293
JO - Journal of Surgical Research
JF - Journal of Surgical Research
SN - 0022-4804
IS - 2
ER -