Clinical application of indocyanine green (ICG) fluorescent imaging of hepatoblastoma
Clinical application of indocyanine green (ICG) fluorescent imaging of hepatoblastoma
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DOI：
10.1016/j.jpedsurg.2015.01.014
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发表时间：
2015-05-01
影响因子：
2.4
通讯作者：
Usui, Noriaki
中科院分区：
文献类型：
--
作者：
Yamamichi, Taku;Oue, Takaharu;Usui, Noriaki
背景/目的：虽然术中吲哚菁绿色（ICG）荧光成像用于肝细胞癌切除术的有用性已被报道，但其用于肝母细胞瘤切除术的有用性仍不清楚。本研究阐明了术中ICG荧光成像用于肝母细胞瘤切除术的可行性。方法：在3例肝母细胞瘤患者中，术前给予ICG后，术中使用近红外荧光成像系统检查原发肿瘤、复发肿瘤和肺转移灶。在第一个病例中，原发性肝母细胞瘤在右肝切除术中显示出强烈的荧光，但在残留的肝脏中没有检测到荧光。在第二个病例中，复发性肿瘤在残留的肝脏和横膈之间显示荧光。完整切除残余肝脏，部分切除膈肌，然后进行肝移植。第3例肺多发转移灶，每一个转移灶均呈荧光阳性，全部切除。结论：术中ICG荧光成像对肝母细胞瘤患者的诊断是可行的，可用于识别肝母细胞瘤小的存活病灶，并确定切除后无残留肿瘤。(C)2015 Elsevier Inc. All rights reserved.
Background/purpose: Although the usefulness of intraoperative indocyanine green (ICG) fluorescent imaging for the resection of hepatocellular carcinoma has been reported, its usefulness for the resection of hepatoblastoma remains unclear. This study clarifies the feasibility of intraoperative ICG fluorescent imaging for the resection of hepatoblastoma.Methods: In three hepatoblastoma patients, a primary tumor, recurrent tumor, and lung metastatic lesions were intraoperatively examined using a near-infrared fluorescence imaging systemafter the preoperative administration of ICG.Results: ICG fluorescent imaging was useful for the surgical navigation in hepatoblastoma patients. In the first case, the primary hepatoblastoma exhibited intense fluorescence during right hepatectomy, but no fluorescence was detected in the residual liver. In the second case, a recurrent tumor exhibited fluorescence between the residual liver and diaphragm. A complete resection of the residual liver, with a partial resection of the diaphragm, followed by liver transplantation was performed. In the third case withmultiple lungmetastases, eachmetastatic lesion showed positive fluorescence, and all were completely resected. These fluorescence-positive lesions were pathologically proven to be viable hepatoblastoma cells.Conclusion: Intraoperative ICG fluorescence imaging for patientswith hepatoblastoma was feasible and useful for identifying small viable lesions and confirming that no remnant tumor remained after resection. (C) 2015 Elsevier Inc. All rights reserved.