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Acta Neurochirurgica

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01-04-2019 | Pituitary Adenoma | Original Article - Pituitaries

Application of indocyanine green fluorescence endoscopic system in transsphenoidal surgery for pituitary tumors

Authors: Kosaku Amano, Yasuo Aihara, Shunsuke Tsuzuki, Yoshikazu Okada, Takakazu Kawamata

Published in: Acta Neurochirurgica | Issue 4/2019

Abstract

Background

For the precise removal of pituitary tumors, preserving the surrounding normal structures, we need real-time intraoperative information on tumor location, margins, and surrounding structures. The aim of this study was to evaluate the benefits of a new intraoperative real-time imaging modality using indocyanine green (ICG) fluorescence through an endoscopic system during transsphenoidal surgery (TSS) for pituitary tumors.

Methods

Between August 2013 and October 2014, 20 patients with pituitary and parasellar region tumors underwent TSS using the ICG fluorescence endoscopic system. We used a peripheral vein bolus dose of 6.25 mg/injection of ICG, started with a time counter, and examined how each tissue type increased and decreased in fluorescence through time.

Results

A total of 33 investigations were performed for 20 patients: 9 had growth hormone secreting adenomas, 6 non-functioning pituitary adenomas, 3 Rathke’s cleft cysts, 1 meningioma, and 1 pituicytoma. After the injection of ICG, the intensity of fluorescence of tumor and normal tissues under near-infrared light showed clear differences. We could differentiate tumor margins from adjacent normal tissues and define clearly the surrounding normal structures using the different fluorescent intensities time changes and tissue-specific fluorescence patterns.

Conclusions

The ICG endoscopic system is simple, user-friendly, quick, cost-effective, and reliable. The method offered real-time information during TSS to delimit pituitary and parasellar region tumor tissue from surrounding normal structures. This method can contribute to the improvement of total removal rates of tumors, reduction of complications after TSS, saving surgical time, and preserving endocrinological functions.

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Title: Application of indocyanine green fluorescence endoscopic system in transsphenoidal surgery for pituitary tumors
Authors: Kosaku Amano
Yasuo Aihara
Shunsuke Tsuzuki
Yoshikazu Okada
Takakazu Kawamata
Publication date: 01-04-2019
Publisher: Springer Vienna
Keyword: Pituitary Adenoma
Published in: Acta Neurochirurgica / Issue 4/2019
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-018-03778-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Application of indocyanine green fluorescence endoscopic system in transsphenoidal surgery for pituitary tumors

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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