Clinical Application of Indocyanine Green and Methylene Blue Three-dimen-sional Dual Fluorescence Imaging in Surgical Management of Uterine Malig-nancies
- VernacularTitle:吲哚箐绿和亚甲蓝三维同屏双荧光显像在子宫恶性肿瘤手术中的临床应用
- Author:
Yousheng WEI
1
;
Ruyu SHAO
1
;
Desheng YAO
1
Author Information
1. 广西医科大学附属肿瘤医院妇瘤科,广西南宁 530000
- Publication Type:Journal Article
- Keywords:
Cervical cancer;
Endometrial cancer;
Sentinel lymph node;
Ureter;
Indocyanine green;
Methylene blue
- From:
Journal of Practical Obstetrics and Gynecology
2025;41(8):683-687
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effectiveness and safety of 3D simultaneous dual fluorescence imaging using indocyanine green(ICG)and methylene blue(MB)in surgeries for malignant uterine tumors.Methods:37 patients who underwent surgery for cervical or endometrial cancer at Guangxi Medical University Cancer Hospital from April 16,2024 to July 19,2024 were included.All patients received simultaneous fluorescence imaging using ICG and MB during surgery.ICG was injected into the cervix for sentinel lymph node(SLN)imaging,and MB was intravenously administered for ureteral imaging.3D fluorescence laparoscopy was used for simultaneous dual fluo-rescence imaging,and the accuracy of localization,signal quality,and clinical effectiveness were assessed using the Likert scale.Adverse events were monitored,and postoperative follow-up was conducted.Results:The SLN visualization rate was 100.0％,and the ureteral visualization rate was 97.3％.The average start time for SLN ima-ging was 4.08±0.64 min after ICG injection,while the average start time for ureteral imaging was 44.86±5.42 min after intravenous MB administration.The main locations of SLN included:internal iliac(13.5％),external iliac(32.4％),and obturator(67.6％).The localization accuracy and signal quality Likert scores of ICG were 4.59±0.45 points and 4.57±0.50 points,respectively;MB were 4.37±0.88 points and 4.28±0.91 points,respectively.There was no ureteral injury during the operation,no urinary fistula after the operation,and no serious adverse e-vents related to the contrast agents were reported.Conclusions:The 3D simultaneous dual fluorescence imaging technique is highly feasible and safe in surgeries for cervical and endometrial cancers.It can effectively locate SLNs and visualize the ureters,simplify the surgical process and reduce difficulty.This technique provides a new auxiliary method for surgeries involving malignant uterine tumors,with promising clinical application prospects.
