Safety and efficacy of indocyanine green fluorescence imaging for real-time guidance of laparoscopic thermal ablation in patients with liver cancer.

IF 3 3区 医学 Q2 ONCOLOGY
International Journal of Hyperthermia Pub Date : 2024-01-01 Epub Date: 2024-02-25 DOI:10.1080/02656736.2024.2306818
Qitao Hu, Zhou Tian, Yongji Sun, Bo Zhang, Zhe Tang
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Abstract

Purpose: To evaluate the safety and efficacy of indocyanine green fluorescence imaging for real-time guidance of laparoscopic thermal ablation in patients with liver cancer.

Materials and methods: A total of 27 patients with 40 liver lesions underwent fluorescence-assisted laparoscopic ablation between January 2020 to March 2023. The sensitivity of indocyanine green (ICG)-fluorescence imaging, technique effectiveness rate and complications of fluorescence-assisted laparoscopic thermal ablation were evaluated.

Results: In total, 33 out of the 40 lesions were identified by ICG-fluorescence imaging technique, with the sensitivity of 82.5%. The sensitivity of ICG-fluorescence imaging of tumor detection in liver surface of parenchyma was significantly higher than that in the deeply located hepatic parenchyma (96.8% vs 33.3%, p = 0.002). ICG-fluorescence imaging procedures detected 4 lesions that cannot be seen on intraoperative ultrasound. It provides clear demarcation lines on the hepatic surface. Technical success is achieved if the necrotic zone had at least a 5 mm ablative margin around the outer edge of the ICG-fluorescence image. Technical success of fluorescence laparoscopic radiofrequency ablation (FLRFA) and fluorescence laparoscopic microwave ablation (FLMWA) was 100% (27/27). Technical effectiveness is defined by the complete necrotic lesions of the local tumor tissue during follow-up. According to the CT/MRI one month after FLRFA or FLMWA, the technical efficacy rate was 92.5% (37/40) and local tumor progression occurred in 7.5% (3/40) of the enrolled lesions. During the follow-up period, no major complications were observed.

Conclusion: ICG-fluorescence imaging guided laparoscopic thermal ablation was feasible, safe and effective.

吲哚菁绿荧光成像用于实时引导肝癌患者腹腔镜热消融的安全性和有效性。
目的:评估吲哚菁绿荧光成像用于实时引导肝癌患者腹腔镜热消融术的安全性和有效性:2020年1月至2023年3月期间,共有27例40个肝脏病灶的患者接受了荧光辅助腹腔镜消融术。对荧光辅助腹腔镜热消融术的吲哚菁绿(ICG)荧光成像灵敏度、技术有效率和并发症进行了评估:结果:在 40 个病灶中,共有 33 个通过 ICG 荧光成像技术识别,灵敏度为 82.5%。ICG荧光成像检测肝实质表面肿瘤的灵敏度(96.8% vs 33.3%,P = 0.002)明显高于肝实质深部的灵敏度。ICG荧光成像程序发现了4个术中超声检查看不到的病灶。它在肝脏表面提供了清晰的分界线。如果坏死区在ICG荧光成像外缘至少有5毫米的消融边缘,则技术成功。荧光腹腔镜射频消融术(FLRFA)和荧光腹腔镜微波消融术(FLMWA)的技术成功率为100%(27/27)。技术有效性的定义是随访期间局部肿瘤组织完全坏死。根据FLRFA或FLMWA术后一个月的CT/MRI检查结果,技术有效率为92.5%(37/40),7.5%(3/40)的入选病灶出现局部肿瘤进展。在随访期间,未发现重大并发症:ICG荧光成像引导的腹腔镜热消融术是可行、安全和有效的。
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来源期刊
CiteScore
5.90
自引率
12.90%
发文量
153
审稿时长
6-12 weeks
期刊介绍: The International Journal of Hyperthermia
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