Department of Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, Yiwu, China.
Department of Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Int J Hyperthermia. 2024;41(1):2306818. doi: 10.1080/02656736.2024.2306818. Epub 2024 Feb 25.
To evaluate the safety and efficacy of indocyanine green fluorescence imaging for real-time guidance of laparoscopic thermal ablation in patients with liver cancer.
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.
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%, = 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.
ICG-fluorescence imaging guided laparoscopic thermal ablation was feasible, safe and effective.
评估吲哚菁绿荧光成像实时指导肝癌腹腔镜热消融的安全性和有效性。
2020 年 1 月至 2023 年 3 月期间，共 27 例 40 个肝脏病变患者接受荧光辅助腹腔镜消融术。评估吲哚菁绿（ICG）荧光成像的灵敏度、技术有效率和并发症。
共 40 个病灶中有 33 个通过 ICG 荧光成像技术检测到，灵敏度为 82.5%。肝表面实质中肿瘤检测的 ICG 荧光成像灵敏度明显高于深部肝实质（96.8%比 33.3%，=0.002）。ICG 荧光成像程序检测到术中超声无法检测到的 4 个病灶。它在肝表面提供了清晰的边界线。如果坏死区域在 ICG 荧光图像外边缘周围至少有 5mm 的消融边界，则可实现技术成功。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）。技术有效性定义为局部肿瘤组织的完全坏死病变。根据 FLRFA 或 FLMWA 后 1 个月的 CT/MRI，技术有效率为 92.5%（37/40），7.5%（3/40）的纳入病灶发生局部肿瘤进展。在随访期间，未观察到重大并发症。
ICG 荧光成像引导腹腔镜热消融是可行、安全且有效的。
