Abstract
Background: Indocyanine green (ICG) fluoresces in the near infra-red (NIR) spectrum. It is widely used in adult oncological surgery for identification of tumor margins and lymph node sampling. However, deliver of ICG in almost all studies is 24 h or more prior to surgery. This is the first study in children to assess its feasibility in minimally invasive surgery (MIS) for oncological disease following ICG injection during induction of anesthesia.
Methods: This was an open label, prospective, single center, feasibility study recruiting consecutive patients eligible for MIS tumor resection or metastectomy. ICG was injected intravenously at induction of anesthesia. Patient demographics, intraoperative appearances, post-operative histopathology, and surgeon Likert ratings were collected.
Results: Fourteen patients were included. Five had lung metastases (Wilms, Osteosarcoma (2), Hodgkin's, melanoma) and 9 had other tumors (neuroblastoma, inflammatory myofibroblastic tumor, ganglioneuroma, phaeochromocytoma, adrenal tumor). Lung metastases were easily identifiable, and all had negative margins. Tumors containing viable disease fluoresced and were completely resected, whilst benign and heavily treated tumors were afluorescent. There were no adverse events relating to ICG or issues with background fluorescence.
Conclusion: Based on this small sample, injection of ICG during induction of anesthesia is safe and effective in showing tumor margins in patients who have had little or no neoadjuvant chemotherapy as well as in metastectomy in Wilms and osteosarcoma. Further studies are needed to confirm these preliminary results.
Original language | English |
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Article number | 103639 |
Number of pages | 6 |
Journal | Photodiagnosis and Photodynamic Therapy |
Volume | 42 |
Early online date | 27 May 2023 |
DOIs | |
Publication status | Published - Jun 2023 |
Bibliographical note
Publisher Copyright:© 2023 Elsevier B.V.
Keywords
- Indocyanine green
- Pediatric oncology
- Surgery
ASJC Scopus subject areas
- Biophysics
- Oncology
- Dermatology
- Pharmacology (medical)