Beren Berber, Vikram Krishnamurthy, Allan Siperstein
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引用次数: 0
Abstract
Introduction: Despite advances in imaging modalities, a significant number of adrenal tumors are considered indeterminate and removed surgically. Currently, there is no intraoperative tool available to provide further information about the nature of indeterminate adrenal tumors. The aim of this study was to investigate whether near-infrared indocyanine green (ICG) imaging can be used in this regard.
Methods: This was an institutional review board-approved study. Within 9 years, 197 patients underwent robotic adrenalectomy with ICG imaging. Adrenal tumors were characterized prospectively as fluorescent or nonfluorescent intraoperatively. ICG was administered as a 2.5 mg dose, one to three times a procedure. No patient developed an allergic reaction. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated.
Results: Robotic transabdominal lateral adrenalectomy was performed in 155 patients and posterior retroperitoneal adrenalectomy in 42 patients. One hundred and eighty-four patients had benign adrenal tumors, 10 patients had malignant tumors, and three patients had tumors of uncertain malignant potential. Sensitivity, specificity, PPV, and NPV to predict a benign tumor were 87%, 38.5%, 95.2%, and 17.2%.
Conclusions: To our knowledge, this is the largest study on ICG imaging of adrenal tumors. High PPV to detect benign tumors suggests a utility of ICG to provide the surgeon with further information about the benign vs malignant nature of indeterminate adrenal tumors taken to surgery.
期刊介绍:
The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.