Real-Time Navigation in Liver Surgery Through Indocyanine Green Fluorescence: An Updated Analysis of Worldwide Protocols and Applications

被引：0

作者：

Avella, Pasquale ^{[1
,2
,3
]}

Spiezia, Salvatore ^{[3
]}

Rotondo, Marco ^{[3
]}

Cappuccio, Micaela ^{[1
]}

Scacchi, Andrea ^{[4
]}

Inglese, Giustiniano ^{[3
]}

Guerra, Germano ^{[3
]}

Brunese, Maria Chiara ^{[3
]}

Bianco, Paolo ^{[2
]}

Tedesco, Giuseppe Amedeo ^{[3
]}

Ceccarelli, Graziano ^{[5
,6
]}

Rocca, Aldo ^{[2
,3
]}

机构：

[1] Univ Naples Federico II, Dept Clin Med & Surg, I-80138 Naples, Italy

[2] Pineta Grande Hosp, Dept Gen Surg, Hepatobiliary & Pancreat Surg Unit, I-81030 Castel Volturno, Italy

[3] Univ Molise, Dept Med & Hlth Sci V Tiberio, I-86100 Campobasso, Italy

[4] Univ Milano Bicocca, Sch Med & Surg, I-20126 Monza, Italy

[5] San Giovanni Battista Hosp, Dept Surg, Div Gen & Minimally Invas Surg, I-06034 Foligno, Italy

[6] San Matteo Hosp, Minimally Invas & Robot Surg Unit, I-06049 Spoleto, Italy

来源：

CANCERS | 2025年 / 17卷 / 05期

关键词：

indocyanine green (ICG) fluorescence; liver surgery; tumor detection; segmentation; fluorescence-guided surgery; NEAR-INFRARED FLUORESCENCE; HEPATOCELLULAR-CARCINOMA; GUIDED SURGERY; LAPAROSCOPIC HEPATECTOMY; STAINING TECHNIQUE; INTRAOPERATIVE USE; IMAGING TECHNIQUES; DONOR HEPATECTOMY; HEPATIC RESECTION; ICG FLUORESCENCE;

D O I：

10.3390/cancers17050872

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Indocyanine green (ICG) fluorescence has seen extensive application across medical and surgical fields, praised for its real-time navigation capabilities and low toxicity. Initially employed to assess liver function, ICG fluorescence is now integral to liver surgery, aiding in tumor detection, liver segmentation, and the visualization of bile leaks. This study reviews current protocols and ICG fluorescence applications in liver surgery, with a focus on optimizing timing and dosage based on clinical indications. Methods: Following PRISMA guidelines, we systematically reviewed the literature up to 27 January 2024, using PubMed and Medline to identify studies on ICG fluorescence used in liver surgery. A systematic review was performed to evaluate dosage and timing protocols for ICG administration. Results: Of 1093 initial articles, 140 studies, covering a total of 3739 patients, were included. The studies primarily addressed tumor detection (40%), liver segmentation (34.6%), and both (21.4%). The most common ICG fluorescence dose for tumor detection was 0.5 mg/kg, with administration occurring from days to weeks pre-surgery. Various near-infrared (NIR) camera systems were utilized, with the PINPOINT system most frequently cited. Tumor detection rates averaged 87.4%, with a 10.5% false-positive rate. Additional applications include the detection of bile leaks, lymph nodes, and vascular and biliary structures. Conclusions: ICG fluorescence imaging has emerged as a valuable tool in liver surgery, enhancing real-time navigation and improving clinical outcomes. Standardizing protocols could further enhance ICG fluorescence efficacy and reliability, benefitting patient care in hepatic surgeries.

引用

页数：22

共 125 条

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