Intraoperative fluorescence image-guided pulmonary segmentectomy

Yujin Oh, Yu Hua Quan, Minji Kim, Beop-Min Kim, Hyun Koo Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)287-293
Number of pages7
JournalJournal of Surgical Research
Volume199
Issue number2
DOIs
Publication statusPublished - 2015 Dec 1

Fingerprint

Indocyanine Green
Segmental Mastectomy
Optical Imaging
Fluorescence
Color
Lung
Rabbits
Swine
Fluorescent Dyes
Pulmonary Artery
Ligation
Technology

Keywords

  • Fluorescence
  • Image-guided surgery
  • Indocyanine green
  • Intraoperative
  • Pulmonary segmentectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Intraoperative fluorescence image-guided pulmonary segmentectomy. / Oh, Yujin; Quan, Yu Hua; Kim, Minji; Kim, Beop-Min; Kim, Hyun Koo .

In: Journal of Surgical Research, Vol. 199, No. 2, 01.12.2015, p. 287-293.

Research output: Contribution to journalArticle

Oh, Yujin ; Quan, Yu Hua ; Kim, Minji ; Kim, Beop-Min ; Kim, Hyun Koo . / Intraoperative fluorescence image-guided pulmonary segmentectomy. In: Journal of Surgical Research. 2015 ; Vol. 199, No. 2. pp. 287-293.
@article{d1692f7e9adb47ecbe50ab1dfb63a8ba,
title = "Intraoperative fluorescence image-guided pulmonary segmentectomy",
abstract = "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.",
keywords = "Fluorescence, Image-guided surgery, Indocyanine green, Intraoperative, Pulmonary segmentectomy",
author = "Yujin Oh and Quan, {Yu Hua} and Minji Kim and Beop-Min Kim and Kim, {Hyun Koo}",
year = "2015",
month = "12",
day = "1",
doi = "10.1016/j.jss.2015.05.009",
language = "English",
volume = "199",
pages = "287--293",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

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

PY - 2015/12/1

Y1 - 2015/12/1

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

UR - http://www.scopus.com/inward/citedby.url?scp=84947867164&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2015.05.009

DO - 10.1016/j.jss.2015.05.009

M3 - Article

VL - 199

SP - 287

EP - 293

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -