North of England Bone and Soft Tissue Tumour Service, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne NE1 4LP, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK.
North of England Bone and Soft Tissue Tumour Service, Royal Victoria Infirmary, Queen Victoria Road, Newcastle Upon Tyne NE1 4LP, UK; Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE1 7RU, UK.
Surg Oncol. 2024 Aug;55:102091. doi: 10.1016/j.suronc.2024.102091. Epub 2024 May 28.
Benign bone and soft tissue tumours encompass a broad, heterogenous range of tumours with varying clinical characteristics. These are often managed surgically with either curettage or marginal excision, but unfortunately have high rates of local recurrence. Indocyanine green (ICG) is a fluorescent dye which can be used to identify solid malignancies intraoperatively but its use is not yet established in benign bone and soft tissue tumours. This study aims to assess whether these tumours fluoresce when administered with ICG pre-operatively and whether this helps surgeons to identify tumour intra-operatively.
Patients with locally aggressive benign bone and soft tissue tumours were administered with 25-75 mg of ICG preoperatively at the induction of anaesthesia. Fluorescence was imaged intraoperatively using the Stryker SPY-PHI camera.
Of the 12 patients included, 11 tumours fluoresced. The surgeons felt the fluorescence guided the procedure in 7 out of the 11 cases which fluoresced. It was felt to be particularly useful in the curettage of bone tumours, in which curettage could be repeated until the absence of fluorescence on imaging. After 12 months, no patients had local recurrence of the tumour. There were no adverse events recorded in this study and surgeons found the technology acceptable.
The use of ICG for fluorescence guided surgery is a promising technology to improve outcomes of surgery for benign bone and soft tissue tumours. Further, longer term, study with a control arm is needed to identify whether it results in a reduction in the local recurrence rate.
良性骨和软组织肿瘤包含广泛的、异质的肿瘤，具有不同的临床特征。这些肿瘤通常通过刮除术或边缘切除术进行手术治疗，但不幸的是，其局部复发率很高。吲哚菁绿（ICG）是一种荧光染料，可用于术中识别实体恶性肿瘤，但在良性骨和软组织肿瘤中的应用尚未确立。本研究旨在评估这些肿瘤在术前给予 ICG 后是否会发出荧光，以及这是否有助于外科医生术中识别肿瘤。
局部侵袭性良性骨和软组织肿瘤患者在麻醉诱导时给予 25-75mg 的 ICG。术中使用 Stryker SPY-PHI 相机进行荧光成像。
在纳入的 12 名患者中，有 11 个肿瘤发出荧光。在发出荧光的 11 例中，有 7 例外科医生认为荧光指导了手术过程。在骨肿瘤的刮除术中，它被认为特别有用，在图像上没有荧光后可以重复刮除。12 个月后，没有患者出现肿瘤局部复发。本研究未记录到不良事件，外科医生认为该技术可以接受。
ICG 用于荧光引导手术是一种有前途的技术，可以改善良性骨和软组织肿瘤的手术结果。此外，还需要进行更长时间的对照研究，以确定它是否能降低局部复发率。
