NIR-II fluorescence image-guided surgery prolongs the relapse-free survival of hepatocellular carcinoma patients

Surgery plays a key role in the treatment of hepatocellular carcinoma (HCC), but radical dissection has long been a challenge.1,2 A series of clinical studies have shown the great potential of fluorescence molecular imaging (FMI) to improve surgical efficacy, by visualizing occult lesions with a superior sensitivity in comparison to direct visual inspection and palpation.3,4 Recently, FMI in the second near-infrared window (900-1880 nm, NIR-II) has shown promising performance, providing enhanced sensitivity and improved depth for intrafirst-in-human study utilizing NIR-II FMI (with ICG) to guide HCC surgery. The data demonstrated that this novel technique was capable of visualizing occult HCC lesions (minimum size <3 mm in diameter) in ultrasonography, CT, MRI and NIR-I FMI (wavelength 700-900 nm); the surgical margin was better delineated, leading to improved surgical decision making.6,7 In this study, we evaluate whether NIR-II FMI can result in year follow-up.