利用近红外吲哚菁绿荧光成像技术区分良性和恶性肾上腺肿瘤

IF 2 3区 医学 Q3 ONCOLOGY
Beren Berber, Vikram Krishnamurthy, Allan Siperstein
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引用次数: 0

摘要

导言:尽管成像模式不断进步,但仍有相当数量的肾上腺肿瘤被认为是不确定的,需要通过手术切除。目前,还没有任何术中工具可提供有关不确定肾上腺肿瘤性质的进一步信息。本研究旨在探讨近红外吲哚菁绿(ICG)成像是否可用于这方面:方法:这是一项经机构审查委员会批准的研究。9年间,197名患者接受了机器人肾上腺切除术,并进行了ICG成像。术中对肾上腺肿瘤进行了荧光或无荧光前瞻性定性。ICG 剂量为 2.5 毫克,每次手术一至三次。没有患者出现过敏反应。计算了敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV):155名患者接受了机器人经腹侧肾上腺切除术,42名患者接受了后腹膜后肾上腺切除术。184例患者为良性肾上腺肿瘤,10例患者为恶性肿瘤,3例患者为恶性可能性不确定的肿瘤。预测良性肿瘤的敏感性、特异性、PPV 和 NPV 分别为 87%、38.5%、95.2% 和 17.2%:据我们所知,这是关于肾上腺肿瘤 ICG 成像的最大规模研究。ICG检测良性肿瘤的PPV很高,这表明ICG可以为外科医生提供更多信息,帮助他们了解手术中不确定的肾上腺肿瘤是良性还是恶性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Use of Near-Infrared Indocyanine Green Fluorescence Imaging to Differentiate Benign Versus Malignant Adrenal Tumors.

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.

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来源期刊
CiteScore
4.70
自引率
4.00%
发文量
367
审稿时长
2 months
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.
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