Application of indocyanine green-based fluorescence imaging in bone and soft tissue tumors
10.3760/cma.j.cn121113-20220915-00546
- VernacularTitle:吲哚菁绿标记荧光成像技术在骨与软组织肿瘤切除手术中的辅助作用
- Author:
Han WANG
1
;
Xiaodong TANG
;
Tao JI
;
Taiqiang YAN
;
Huayi QU
;
Dasen LI
;
Wei GUO
Author Information
1. 北京大学人民医院骨肿瘤科，北京 100044
- Keywords:
Bone neoplasms;
Soft tissue neoplasms;
Spectroscopy, near-infrared;
Optical imaging
- From:
Chinese Journal of Orthopaedics
2023;43(9):574-580
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the role and value of indocyanine green (ICG) fluorescence imaging in the surgery of bone and soft tissue tumors.Methods:A total of 38 patients with bone and soft tissue tumors, including 17 males and 21 females, aged 36±21 years (range 5-75 years), who underwent resection with application of ICG-based NIR imaging were retrospectively analyzed. ICG was intravenously administrated at a dose of 2 mg/kg on the day before surgery. Intraoperative NIR imaging was performed to confirm the tumor fluorescence and to detect residual tumor after tumor resection. The NIR imaging was post hoc analyzed to explore the influence factor of tumor stain rate and SBR value.Results:Tumor staining with ICG was successful in 34 of the 38 patients, with an overall staining rate of 90%. The ICG tumor stain rate was not influenced by different pathology types, malignant or benign pathology, the reception of neoadjuvant chemotherapies or not, and the length of time between drug administration and surgery ( P>0.05). The median SBR of 34 patients with successful tumor staining was 2.9 (2.3, 5.7). Different pathological types, malignant or benign pathology, whether to receive neoadjuvant chemotherapy, preoperative ICG administration time, preoperative dose of denosumab administration in giant cell tumor of bone patients and tumor response to neoadjuvant chemotherapy had no significant effects on SBR ( P>0.05). After tumor resection, a total of 57 pieces of tissue with residual fluorescence signals were detected and resected under the fluorescence guidance, 30 of which were pathologically confirmed to contain residual tumor lesions, with an overall accuracy of 53%. The accuracy of intralesional resection was significantly higher than that of en bloc resection (71% vs. 16%, χ 2=15.51, P=0.000). Conclusion:A high percentage of bone and soft tissue tumors can be stained with ICG. The tumor stain of ICG was stable and not easily influenced by external factors. This technique was useful to detect residual tumors, especially after piecemeal resection.
