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ICG‐fluorescence imaging for detection of peritoneal metastases and residual tumoral scars in locally advanced ovarian cancer: A pilot study
Author(s) -
Veys Isabelle,
Pop FlorinCatalin,
Vankerckhove Sophie,
Barbieux Romain,
Chintinne Marie,
Moreau Michel,
Nogaret JeanMarie,
Larsimont Denis,
Donckier Vincent,
Bourgeois Pierre,
Liberale Gabriel
Publication year - 2018
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.24807
Subject(s) - medicine , scars , indocyanine green , ovarian cancer , laparotomy , cancer , radiology , pathology , nuclear medicine
Background and Objectives No intraoperative imaging techniques exist for detecting tumor nodules or tumor scar tissues in patients treated with upfront or interval cytoreductive surgery (CS) after neoadjuvant chemotherapy (NAC). The aims of this study were to evaluate the role of indocyanine green (ICG) fluorescence imaging (FI) for the detection of peritoneal metastases (PM) and evaluate whether it can be used to detect remnant tumor cells in scar tissue. Methods Patients with PM from ovarian cancer admitted for CS were included. ICG, at 0.25 mg per kg of patient weight, was injected intraoperatively after explorative laparotomy before CS. Results A total of 108 peritoneal lesions, including 25 scars, were imaged in 20 patients. Seventy‐three were malignant (67.6%) and 35 benign (32.4%). The mean Tumor to Background Ratio (ex vivo) was 1.8 (SD 1.3) in malignant and 1.0 (SD 0.79) in benign nodules ( P = 0.007). Of 25 post‐NAC scars, the mean Tumor to Background Ratio (TBR) (in vivo) was 2.06 (SD 1.15) in malignant and 1.21 (SD 0.50) in benign nodules ( P = 0.26). The positive predictive value of ICG‐FI to detect tumor cells in scars was 57.1%. Conclusions ICG‐FI is accurate to demonstrate PM in ovarian cancer but unable to discriminate between benign and malignant post‐NAC.