Peyrat Patrice, Blanc Ellen, Guillermet Stéphanie, Chen Yao, Ferlay Céline, Perol David, Basso Valéria, Rivoire Michel, Dupré Aurélien
Department of Surgery, Centre Léon Bérard, Lyon, France.
Experimental Surgical Unit, Centre Léon Bérard, Lyon, France.
J Surg Oncol. 2018 Apr;117(5):922-927. doi: 10.1002/jso.25011. Epub 2018 Feb 23.
Fluorescence imaging using indocyanine green (ICG) is undergoing extensive development. This study aimed to assess the merits of ICG in regard to hepatic surgery.
Patients with liver lesions that required a resection were eligible. They received an injection of ICG the day before the surgery. Step 1 allowed assessment of use of the medical device under surgical conditions. Steps 2 and 3 assessed the capacity of the MD to detect known tumorous lesions and to spot a predefined area of the liver following injection of ICG into the portal vein (ICGp).
The 1st step allowed for validation of the MD use with three patients. Between 04-2013 and 04-2015, 45 pts were included (40 eligible) in steps 2 and 3. All of the tumorous lesions (95/119) exhibited fluorescence. Four new metastasis were detected in 3 pts, and two missing metastases in 1 pt. False positive were 22%. The maximal depth for detection by fluorescence was 13 mm. Injection of ICGp allowed the corresponding anatomical area to be identified in 16/20 patients.
This study confirmed that intraoperative fluorescence is a helpful and relevant tool for the liver surgeon (NCT 01738217).
使用吲哚菁绿（ICG）的荧光成像技术正在广泛发展。本研究旨在评估ICG在肝脏手术方面的优点。
符合条件的患者为患有需要切除的肝脏病变者。他们在手术前一天接受ICG注射。步骤1评估该医疗设备在手术条件下的使用情况。步骤2和3评估该医疗设备在向门静脉注射ICG（ICGp）后检测已知肿瘤病变以及识别肝脏预定义区域的能力。
步骤1通过3例患者验证了该医疗设备的使用情况。在2013年4月至2015年4月期间，45例患者（40例符合条件）纳入步骤2和3。所有肿瘤病变（95/119）均显示荧光。在3例患者中检测到4处新转移灶，在1例患者中发现2处漏诊转移灶。假阳性率为22%。荧光检测的最大深度为13毫米。注射ICGp后，16/20例患者能够识别相应的解剖区域。
本研究证实术中荧光对肝脏外科医生来说是一种有用且相关的工具（NCT 01738217）。
