Original articleGeneral thoracicLocalization of Pulmonary Nodules Using Navigation Bronchoscope and a Near-Infrared Fluorescence Thoracoscope
Section snippets
Fluorescence intensity of ICG in lung tissue
Indocyanine green has a binding ability of 98% to plasma proteins; 80% to globulins and 20% to alpha-lipoprotein and albumin [14]. In exciting with 780 to 820 nm of infrared light, ICG emits the fluorescence of the peak wavelength of 810 nm in water and approximately 830 nm in blood. The fluorescence of different dilutions of ICG mixed with albumin was imaged and semiquantified by the Maestro imaging system (Cambridge Research & Instrumentation, Inc, Woburn, MA) in vitro. Each 100 mcL of ICG
In Vitro and Ex Vivo Study
The ICG exhibited a maximum fluorescence of 830 nm infrared light at a concentration of 1.5 × 10−1 (mg/mL) with the presence of 2.0 g/dL of albumin (Figs 1A, 1B). The different concentrations of albumin were mixed to 1.5 × 10−1 g/L of ICG in vitro (Fig 1D). The level of fluorescence increased with a logarithmic curve (Fig 1D). When ICG was dropped onto the sliced porcine lung tissue (Fig 1C), ICG alone (1.5 × 10−1 g/L) showed an increased fluorescence that is equivalent to that of ICG with
Comment
The current study demonstrates that the application of ICG fluorescence dye can be used to localize small-sized pulmonary nodules during minimally invasive thoracic surgery. The excitation of ICG by a class 3 laser light and the deep tissue penetration properties of NIR emission light both contribute to the visualization of the small amount of diluted ICG staying in lung parenchyma. Unlike color dye detection by a white light endoscope, the specific wavelength of ICG fluorescence is always
References (35)
- et al.
Usefulness of circumference difference for estimating the likelihood of malignancy in small solitary pulmonary nodules on CT
Lung Cancer
(2007) - et al.
Video-assisted thoracoscopic surgery for small indeterminate pulmonary nodules: indications for preoperative marking
Chest
(1999) - et al.
Indication for preoperative localization of small peripheral pulmonary nodules in thoracoscopic surgery
J Thorac Cardiovasc Surg
(2002) - et al.
Needle/wire lung nodule localization for thoracoscopic resection
Chest
(1993) - et al.
Computed tomography-guided preoperative radiotracer localization of nonpalpable lung nodules
Ann Thorac Surg
(2010) - et al.
Sentinel lymph node detection in skin cancer patients using real-time fluorescence navigation with indocyanine green: preliminary experience
J Plast Reconstr Aesthet Surg
(2009) - et al.
Breast cancer sentinel lymph node mapping using near infrared guided indocyanine green and indocyanine green–human serum albumin in comparison with gamma emitting radioactive colloid tracer
Eur J Surg Oncol
(2012) - et al.
Bronchoscopic dye injection for localization of small pulmonary nodules in thoracoscopic surgery
Ann Thorac Surg
(2001) Early lung cancer action project: overall design and findings from baseline screening
Cancer
(2000)- et al.
Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers
Eur Radiol
(2004)
Screening for early lung cancer with low-dose spiral CT: prevalence in 817 asymptomatic smokers
Radiology
Screening for lung cancer with low-dose spiral computed tomography
Am J Respir Crit Care Med
Reduced lung-cancer mortality with low-dose computed tomographic screening
N Engl J Med
CT-directed microcoil localization of small peripheral lung nodules: a feasibility study in pigs
J Invest Surg
Peripheral lung nodules: fluoroscopically guided video-assisted thoracoscopic resection after computed tomography-guided localization using platinum microcoils
Ann Surg
Lung nodules: CT-guided placement of microcoils to direct video-assisted thoracoscopic surgical resection
Radiology
In patients undergoing video-assisted thoracoscopic surgery excision, what is the best way to locate a subcentimetre solitary pulmonary nodule in order to achieve successful excision?
Interact Cardiovasc Thorac Surg
Cited by (91)
Chemical Localization With Robotic Bronchoscopy: Can It Aid Resection of Subsolid Lung Nodules?
2024, Journal of Surgical ResearchApplicability of autofluorescence and fluorescent probes in the trans-surgical of oral carcinomas: A systematic review
2023, Photodiagnosis and Photodynamic TherapyCitation Excerpt :In general, the results found in this study were satisfactory for fluorescent probes, making them a promising alternative in transsurgery, since studies have shown their effectiveness both in oral tumors and in other types of tumors. Regarding the others tumors emphasize some studies that demonstrated that, like a retrospective observational, case-control study carried out between the years 2004 and 2009 showed that the use of this method significantly reduced the rate of local recurrence in high-grade and early-stage pre-invasive oral cancers [33]; still, due to its ability to visualize neoplastic vascularization, optical imaging has shown good results in patients during liver resection for the detection of colorectal cancer metastases [77], and in the endoscopic detection of pulmonary nodules [94] and early gastric cancer [95]. In a systematic review [96] that used laparoscopic imaging techniques for intraoperative identification of endometriosis, the reported sensitivity of 5-ALA and autofluorescence (AFI) to identify endometriosis ranged from 91% to 100%, compared with 48% to 69% for conventional white light (WL) laparoscopy.
Refining the Diagnosis, Minimizing the Approach: Advances in Pulmonary Nodule Marking Strategies
2022, Archivos de Bronconeumologia[Translated article] Refining the Diagnosis, Minimizing the Approach: Advances in Pulmonary Nodule Marking Strategies
2022, Archivos de Bronconeumologia