scholarly journals Attempt of Real-Time Near-Infrared Fluorescence Imaging Using Indocyanine Green (ICG) in Radical Resection of Gallbladder Cancer: A Case Report

2021 ◽  
Vol 8 ◽  
Author(s):  
Yang Yu ◽  
Lin Xiang ◽  
Yuping Bai ◽  
Ewetse Paul Maswikiti ◽  
Baohong Gu ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Real Time ◽  
Near Infrared ◽  
Operative Procedure ◽  
Biliary Tree ◽  
Radical Resection ◽  
Older Woman ◽  
Near Infrared Fluorescence ◽  
Nirf Imaging ◽  
Near Infrared Fluorescence Imaging

Surgery is the mainstay of treatment for resectable gallbladder cancer. Near-infrared fluorescence (NIRF) imaging using ICG is an innovation in laparoscopic surgery, which can provide real-time navigation during the whole operation. In this article, we present a 56-year older woman with gallbladder cancer, in which we evaluated the applicability of NIRF imaging using ICG for tumor and biliary tree visualization during the operative procedure of gallbladder cancer. The tumor and biliary tree were clearly visualized by utilizing a green fluorescence dye. The patient was successfully operated radical resection of gallbladder cancer under fluorescence laparoscope, without any complications. According to this case, the utilization of ICG based NIRF imaging is feasible and beneficial in identifying tumors and the biliary tree during radical resection. It can assist in the achievement of a negative margin and lymphatic clearance around the biliary tree. However, further studies are needed to corroborate the results of this case.

scholarly journals Intra-operative assessment of the vascularisation of a cross section of the meniscus using near-infrared fluorescence imaging

2021 ◽  
Author(s):  
Peter van Schie ◽  
Thies J. N. van der Lelij ◽  
Maxime Gerritsen ◽  
Ruben P. J. Meijer ◽  
Ewoud R. A. van Arkel ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Cross Section ◽  
Near Infrared ◽  
Level Of Evidence ◽  
Camera System ◽  
Near Infrared Fluorescence ◽  
Nirf Imaging ◽  
Total Knee ◽  
Operative Assessment ◽  
Near Infrared Fluorescence Imaging

Abstract Purpose The purpose of this study was to assess whether the vascularisation of the meniscus could be visualised intra-operatively using near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) in patients undergoing total knee arthroplasty (TKA). Methods The anterior horn (i.e., Cooper classification: zones C and D) of the meniscus that was least affected (i.e., least degenerative) was removed during TKA surgery in ten patients to obtain a cross section of the inside of the meniscus. Thereafter, 10 mg of ICG was injected intravenously, and vascularisation of the cross section of the meniscus was assessed using the Quest spectrum NIRF camera system. We calculated the percentage of patients in whom vascularisation was observed intra-operatively using NIRF imaging compared to immunohistochemistry. Results Meniscal vascularisation using NIRF imaging was observed in six out of eight (75%) patients in whom vascularisation was demonstrated with immunohistochemistry. The median extent of vascularisation was 13% (interquartile range (IQR) 3–28%) using NIRF imaging and 15% (IQR 11–23%) using immunohistochemistry. Conclusion This study shows the potential of NIRF imaging to visualise vascularisation of the meniscus, as vascularisation was observed in six out of eight patients with histologically proven meniscal vascularisation. Level of evidence IV.

scholarly journals Intraoperative Near-Infrared Fluorescence Imaging With Second-Window Indocyanine-Green Offers Accurate and Real-Time Correction for Brain Shift and Anatomic Inconsistencies in Framless Neuronavigation

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Steve Sungwon Cho ◽  
Ashwin G Ramayya ◽  
Clare W Teng ◽  
Steven Brem ◽  
Sunil Singhal ◽  
...  
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Infrared Imaging ◽  
P Value ◽  
Brain Shift ◽  
Intracranial Tumors ◽  
Near Infrared Imaging ◽  
Near Infrared Fluorescence ◽  
Near Infrared Fluorescence Imaging

Abstract INTRODUCTION Neuronavigation allows neurosurgeons to localize intracranial structures in 3D space and has been shown to have positive impacts on patient survival in neuro-oncology surgery. However, its major limitation is the intraoperative brain-shift phenomenon, in which the brain moves during surgery due to physical, surgical, and/or biological factors, invalidating the preoperative registration and leading to inaccuracies in the cranium. One reliable way to account for brain-shift intraoperatively may be to use tumor-targeting near-infrared fluorophores, such as ICG accumulating in neoplastic tissue (ie, Second-Window ICG), which offers real-time visualization of tumors through normal cortex and dura. METHODS Patients undergoing craniotomy for primary resection of intracranial tumors were enrolled under an ongoing clinical trial investigating the efficacy of SWIG. For this analysis, retrospective data were collected on patients in whom neuronavigation was used to plan the craniotomy in such a way as to place the tumor in the center of the craniotomy (ie, parasagittal tumors, skull-base tumors, and large/asymmetrical tumors were excluded). During surgery, near-infrared imaging was performed before and after durotomy to localize the gross tumor. Image analysis was performed to measure the deviation between the craniotomy center and the center of the tumor as seen with near-infrared fluorescence. RESULTS A total of 63 patients (24 high-grade-gliomas, 12 meningiomas, 25 metastases, 2 others) were included in this preliminary analysis. Neuronavigation demonstrated a median deviation of 22.4% (range 7.7%-44.4%) relative to craniotomy size. Patient position was a significant predictor of neuronavigation inaccuracy, with the prone position having significantly higher inaccuracy (28.5 ± 8.8%) compared to the supine (19.3 ± 9.2%, P-value = .015) or the lateral (17.9 ± 6.6%, P-value = .012) positions. Additionally, the neuronavigation device used and postgraduate training level of the residents performing the registration trended towards significance on multivariate analysis. In contrast, near-infrared fluorescence perfectly delineated the tumor in all cases. CONCLUSION We demonstrate that near-infrared fluorescence imaging offers more accurate localization of intracranial tumors compared to frameless neuronavigation. Near-infrared imaging could potentially be used to adjust neuronavigation registrations intraoperatively to enhance accuracy. Further prospective studies with distance measurements could better explore this potential benefit of intraoperative near-infrared imaging.

scholarly journals Near Infrared Fluorescence Imaging to Assess Breast Flap Perfusion and Prevention of Ischemia: Case Report

2019 ◽  
Vol 103 (9-10) ◽  
pp. 473-476
Author(s):  
Ju Yong Cheong ◽  
David Goltsman ◽  
Sanjay Warrier
Keyword(s):  
Fluorescence Imaging ◽  
Near Infrared ◽  
Imaging System ◽  
Skin Flap ◽  
Color Temperature ◽  
Near Infrared Fluorescence ◽  
Clinical Method ◽  
Nirf Imaging ◽  
Near Infrared Fluorescence Imaging ◽  
Flap Perfusion

Introduction: Breast skin flap ischemia and necrosis is a serious consequence of breast reconstruction with reported incidence of 10% to 15%. Current clinical method of assessing breast skin flap perfusion includes combination of skin color, temperature, dermal edge bleeding, and capillary refill. Given the high incidence of ischemia and the presence of certain cohort of patient with greater risk, there is a need for an objective method of assessing the skin flap perfusion. Near infrared fluorescence imaging using indocyanine green is a new technique of assessing skin flap perfusion. We present a first reported case where breast skin flap ischemia was objectively identified intraoperatively by NIRF imaging, and this ischemia was reversed through active intra- and postoperative measures, which was objectively again identified by NIRF imaging. Case presentation: A 36-year-old female patient underwent bilateral nipple sparing mastectomies with immediate reconstruction using tissue expanders. Clinical assessment of the breast skin flap was equivocal. NIRF imaging using SPY imaging system (Novadaq Technologies Inc, Toronto, ON, Canada) showed poor perfusion in the periareolar region. As a result, it was decided to completely deflate the expander, actively warm the skin flap and encourage cutaneous perfusion through use of topical glycerin trinitrate patch. A repeat NIRF imaging 48 hours showed 10-fold increase in perfusion in the skin flap. Conclusion: NIRF imaging is a useful tool in assessing breast skin perfusion and to predict potential ischemia, which can aid in surgeon's management of patient.

scholarly journals Real-time near-infrared fluorescence imaging using cRGD-ZW800-1 for intraoperative visualization of multiple cancer types

Oncotarget ◽  
2017 ◽  
Vol 8 (13) ◽  
pp. 21054-21066 ◽  
Author(s):  
Henricus J.M. Handgraaf ◽  
Martin C. Boonstra ◽  
Hendrica A.J.M. Prevoo ◽  
Joeri Kuil ◽  
Mark W. Bordo ◽  
...  
Keyword(s):  
Real Time ◽  
Fluorescence Imaging ◽  
Near Infrared ◽  
Multiple Cancer ◽  
Near Infrared Fluorescence ◽  
Cancer Types ◽  
Near Infrared Fluorescence Imaging ◽  
Intraoperative Visualization

scholarly journals Indocyanine Green Near-Infrared Fluorescence Imaging-Guided Laparoscopic Heminephrectomy for Left Ureteral Cancer in Patient with Horseshoe Kidney

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Takao Natsuyama ◽  
Yozo Mitsui ◽  
Masato Uetani ◽  
Shigeyuki Ohta ◽  
Shin-ichi Hisasue
Keyword(s):  
Indocyanine Green ◽  
Near Infrared ◽  
Imaging System ◽  
Left Kidney ◽  
Horseshoe Kidney ◽  
Near Infrared Fluorescence ◽  
Nirf Imaging ◽  
Novel Approach ◽  
The Right ◽  
Near Infrared Fluorescence Imaging

Laparoscopic surgery for patients with a horseshoe kidney is challenging because of the location, aberrant vasculature, and difficulty with division of the isthmus with adequate hemostasis. We herein report performance of a laparoscopic heminephrectomy for left ureteral cancer in a patient with a horseshoe kidney under guidance from near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG). A 62-year-old male was referred to our hospital for treatment of left ureteral cancer associated with a horseshoe kidney. We performed a laparoscopic left nephroureterectomy and bladder resection in June 2017. During the operation, the NIRF imaging system was used to evaluate the border of the kidney parenchyma isthmus after ligation of the left kidney vasculature supply. Interestingly, the dominant region of the right kidney showed strong ICG fluorescence as compared to the left kidney region. With the assistance of ICG-based NIRF imaging, isthmus division was performed with monopolar scissors and adequate hemostasis was obtained by electrocautery coagulation. This is the first report of use of an ICG-based NIRF imaging system and this novel approach can help to demarcate the left moiety isthmus from right one with more certainty.

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