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Pediatric Surgery International
Published in: Pediatric Surgery International 1/2023

01-12-2023 | Original Article

Effectiveness of indocyanine green fluorescence imaging in resection of hepatoblastoma

Authors: Qiyang Shen, Xingyu Liu, Sirui Pan, Tao Li, Jianfeng Zhou

Published in: Pediatric Surgery International | Issue 1/2023

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Abstract

Objective

The present research aimed to analyze the application of indocyanine green (ICG) fluorescence contrast technique in the resection of hepatoblastoma (HB) in children, and to discuss the use of ICG in the surgery of HB and the value of guidance.

Methods

We retrospectively analyzed the data of 23 children with HB resected using ICG fluorescence contrast technique at the Children’s Hospital of Nanjing Medical University from June 2020 to September 2022, including 16 boys and 7 girls, aged 5 days to 80 months. The patients were administered with an ICG injection of 0.1 mg/kg around 24–48 h before surgery. The surgical margin was detected by real-time fluorescence imaging and confirmed by postoperative pathology.

Results

All primary lesions showed bright fluorescence in 23 HB cases. 22 had clear borders with normal liver tissue, while one neonatal case showed no difference between tumor and background. 13 anatomic resection and 10 non-anatomic resection were performed with ICG fluorescence navigation. The surface of the residual liver was scattered with multiple tumor fluorescence, which was then locally enucleated according to the fluorescence. 22 isolated specimens were dissected and fluorescently visualized. Pathology identified deformed, vacuolated and densely arranged hepatocytes resembling pseudo-envelope changes without tumor residual, due to the compression of the tissue at the site of circumferential imaging.

Conclusion

The ring ICG fluorescence imaging of HB indicates the tumor resection boundary effectively, especially in multiple lesions cases.
Literature
1.
O’Neill AF et al (2017) Characterization of pulmonary metastases in children with hepatoblastoma treated on children’s oncology group protocol AHEP0731 (the treatment of children with all stages of hepatoblastoma): a report from the children’s oncology group. J Clin Oncol 35(30):3465–3473CrossRefPubMedPubMedCentral
2.
Meyers RL et al (2017) Risk-stratified staging in paediatric hepatoblastoma: a unified analysis from the children’s hepatic tumors international collaboration. Lancet Oncol 18(1):122–131CrossRefPubMed
3.
4.
Kalish JM et al (2017) Surveillance recommendations for children with overgrowth syndromes and predisposition to wilms tumors and hepatoblastoma. Clin Cancer Res 23(13):e115–e122CrossRefPubMedPubMedCentral
5.
Sivaprakasam P et al (2011) Survival and long-term outcomes in children with hepatoblastoma treated with continuous infusion of cisplatin and doxorubicin. J Pediatr Hematol Oncol 33(6):e226–e230CrossRefPubMed
6.
Hooks KB et al (2018) New insights into diagnosis and therapeutic options for proliferative hepatoblastoma. Hepatology 68(1):89–102CrossRefPubMed
7.
Choy G, Choyke P, Libutti SK (2003) Current advances in molecular imaging: noninvasive in vivo bioluminescent and fluorescent optical imaging in cancer research. Mol Imaging 2(4):303–312CrossRefPubMed
8.
9.
Landsman ML et al (1976) Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol 40(4):575–583CrossRefPubMed
10.
Yamada Y et al (2019) Fluorescence-guided surgery for hepatoblastoma with indocyanine green. Cancers (Basel) 11(8):1215CrossRefPubMed
11.
Ishizawa T et al (2009) Intraoperative fluorescent cholangiography using indocyanine green: a biliary road map for safe surgery. J Am Coll Surg 208(1):e1-4CrossRefPubMed
12.
Fox IJ et al (1957) A tricarbocyanine dye for continuous recording of dilution curves in whole blood independent of variations in blood oxygen saturation. Proc Staff Meet Mayo Clin 32(18):478–484PubMed
13.
Speich R et al (1988) Anaphylactoid reactions after indocyanine-green administration. Ann Intern Med 109(4):345–346CrossRefPubMed
14.
Ishizawa T et al (2014) Mechanistic background and clinical applications of indocyanine green fluorescence imaging of hepatocellular carcinoma. Ann Surg Oncol 21(2):440–448CrossRefPubMed
15.
Cheung TT et al (2018) Pure laparoscopic hepatectomy with augmented reality-assisted indocyanine green fluorescence versus open hepatectomy for hepatocellular carcinoma with liver cirrhosis: a propensity analysis at a single center. Asian J Endosc Surg 11(2):104–111CrossRefPubMed
16.
Wang Z et al (2018) Method for real-time tissue quantification of indocyanine green revealing optimal conditions for near infrared fluorescence guided surgery. Anal Chem 90(13):7922–7929CrossRefPubMed
17.
de Graaf W et al (2011) Transporters involved in the hepatic uptake of (99m)Tc-mebrofenin and indocyanine green. J Hepatol 54(4):738–745CrossRefPubMed
18.
Lake CM et al (2021) Indocyanine green is a sensitive adjunct in the identification and surgical management of local and metastatic hepatoblastoma. Cancer Med 10(13):4322–4343CrossRefPubMedPubMedCentral
19.
20.
Narasaki H et al (2017) Intraoperative real-time assessment of liver function with near-infrared fluorescence imaging. Eur Surg Res 58(5–6):235–245CrossRefPubMed
21.
Nakaseko Y, Ishizawa T, Saiura A (2018) Fluorescence-guided surgery for liver tumors. J Surg Oncol 118(2):324–331CrossRefPubMed
22.
Yamamichi T et al (2015) Clinical application of indocyanine green (ICG) fluorescent imaging of hepatoblastoma. J Pediatr Surg 50(5):833–836CrossRefPubMed
23.
Cho YJ et al (2021) The advantages of indocyanine green fluorescence imaging in detecting and treating pediatric hepatoblastoma: a preliminary experience. Front Pediatr 9:635394CrossRefPubMedPubMedCentral
Metadata
Title
Effectiveness of indocyanine green fluorescence imaging in resection of hepatoblastoma
Authors
Qiyang Shen
Xingyu Liu
Sirui Pan
Tao Li
Jianfeng Zhou
Publication date
01-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Surgery International / Issue 1/2023
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-023-05465-3

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