Intraoperative pulmonary neoplasm identification using near-infrared fluorescence imaging

Hyun Koo Kim, Yu Hua Quan, Byeong Hyeon Choi, Ji Ho Park, Kook Nam Han, Yeonho Choi, Beop-Min Kim, Young Ho Choi

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

OBJECTIVES: Near-infrared (NIR) fluorescence imaging provides surgeons with real-time visual information during surgery. The purpose of this pilot trial was to evaluate the safety and feasibility of the intraoperative detection of pulmonary neoplasms with NIR fluorescence imaging after low-dose indocyanine green (ICG) injection. METHODS: Eleven consecutive patients who were scheduled to undergo resection of pulmonary neoplasms were enrolled in this study. ICG (1 mg/kg) was administered intravenously 1 day before surgery, and the retrieved surgical specimens were examined for fluorescence signalling by using NIR fluorescence imaging system on a back table in the operating room. We analysed the fluorescence intensity, pathology, size, depth from the pleural surface and metabolic activity of the pulmonary neoplasms. RESULTS: Fluorescence signalling was detected in all specimens except in one from a patient with primary lung cancer. Two false-positive cases that presented no residual tumour with obstructive pneumonitis, after concurrent chemoradiation therapy for primary lung cancer before the operation, were identified, and their fluorescence intensity was 8.6 ± 0.4. The mean fluorescence intensity of the eight pulmonary tumours was 3.4 ± 1.9, and these tumours did not differ in pathology, size, depth from the pleural surface or metabolic activity. CONCLUSIONS: NIR fluorescence imaging could safely identify pulmonary neoplasms after the systemic injection of ICG. In addition, lowdose ICG is sufficient for NIR fluorescence imaging of pulmonary neoplasms. However, because the passive accumulation of ICG could not be used to discriminate tumours with inflammation, tumour-targeted fluorescence should be developed to solve this problem in the future.

Original languageEnglish
Article numberezv367
Pages (from-to)1497-1502
Number of pages6
JournalEuropean Journal of Cardio-thoracic Surgery
Volume49
Issue number5
DOIs
Publication statusPublished - 2016 May 1

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Optical Imaging
Indocyanine Green
Lung Neoplasms
Fluorescence
Neoplasms
Operating Tables
Pathology
Injections
Residual Neoplasm
Ambulatory Surgical Procedures
Pneumonia
Inflammation
Safety
Lung

Keywords

  • Fluorescence
  • Pulmonary neoplasm
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Intraoperative pulmonary neoplasm identification using near-infrared fluorescence imaging. / Kim, Hyun Koo ; Quan, Yu Hua; Choi, Byeong Hyeon; Park, Ji Ho; Han, Kook Nam; Choi, Yeonho; Kim, Beop-Min; Choi, Young Ho.

In: European Journal of Cardio-thoracic Surgery, Vol. 49, No. 5, ezv367, 01.05.2016, p. 1497-1502.

Research output: Contribution to journalArticle

Kim, Hyun Koo ; Quan, Yu Hua ; Choi, Byeong Hyeon ; Park, Ji Ho ; Han, Kook Nam ; Choi, Yeonho ; Kim, Beop-Min ; Choi, Young Ho. / Intraoperative pulmonary neoplasm identification using near-infrared fluorescence imaging. In: European Journal of Cardio-thoracic Surgery. 2016 ; Vol. 49, No. 5. pp. 1497-1502.
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