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A novel image‐guided surgery of hepatocellular carcinoma by indocyanine green fluorescence imaging navigation
Author(s) -
Gotoh Kunihito,
Yamada Terumasa,
Ishikawa Osamu,
Takahashi Hidenori,
Eguchi Hidetoshi,
Yano Masahiko,
Ohigashi Hiroaki,
Tomita Yasuhiko,
Miyamoto Yasuhide,
Imaoka Shingi
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21272
Subject(s) - indocyanine green , medicine , hepatocellular carcinoma , laparotomy , radiology , hepatectomy , nuclear medicine , pathology , resection , surgery
Background and Objectives The clear delineation between tumor and normal tissue is ideal for real‐time surgical navigation imaging. We present a novel indocyanine green (ICG) fluorescence imaging technique to visualize hepatocellular carcinoma (HCC). Methods Ten patients with solitary HCC underwent hepatectomy between February and September 2007 at Osaka Medical Center for Cancer and Cardiovascular Diseases. ICG had been injected intravenously several days before surgery at a dose of 0.5 mg/kg body weight. After laparotomy, the liver was inspected with intraoperative ultrasonography (IOUS), and then with a near‐infrared (NIR) fluorescence imaging system (PDE; Hamamatsu Photonics K.K. Hamamatsu, Japan). Results All the 10 primary tumors showed bright fluorescent signals and could be completely removed with negative margins under the guide of PDE. In four cases (40.0%), new HCC nodules that were not detected by use of any preoperative examinations including IOUS were detected by PDE. These newly identified HCC nodules were very small in size and most of the tumors were well‐differentiated HCCs. Conclusions This novel technique is simple and safe, and is therefore considered to be a promising tool for routine intraoperative imaging during a hepatic resection and further clinical exploration for HCC. J. Surg. Oncol. 2009;100:75–79. © 2009 Wiley‐Liss, Inc.