초록접수 현황
| 15F-019 | 구연 발표 |
Optimization of Intraoperative Pulmonary Neoplasm Identification Using Near-infrared Fluorescence Imaging
김현구¹, 전옥화¹, 김민지², 최병현¹, 노지윤¹, 한국남¹, 김법민², 최영호¹
고려대학교 의과대학 구로병원 흉부외과학교실¹, 고려대학교 의과대학 구로병원 바이오의공학과²
Background : In the previous study, we found that pulmonary neoplasm could be identified by intraoperative Near-infrared (NIR) fluorescence imaging system 24 hours after systemic injection of low-dose ICG (1 mg/kg) indocyanine green (ICG). However, there is no consensus about optimal injection time of ICG in lung cancer patients. This study was performed as the first-in-human trial to evaluate optimal injection time of ICG for detecting lung cancer during surgery.
Methods : Twenty-eight consecutive patients who were scheduled to undergo pulmonary resection for pulmonary neoplasms were enrolled in this study. ICG (1 mg/kg) was administered intravenously prior to operation according to the time allocation. The retrieved surgical specimens were examined for signal to background ratio (SBR) using custom-built intraoperative color and fluorescence merged imaging system (ICFIS) on a back table at 3, 6, 12, and 24 hours after injection. We analyzed the fluorescence intensity and the histologic characteristics of the specimens.
Results : Patients had primary lung cancer in 20 and metastatic lung cancer in 8. ICG fluorescent imaging was observed in all patients (100%). The SBR of pulmonary neoplasm was 2.4±1.88 in 3hr group (N=7), 3.1±1.91 in 6hr group (N=8), 2.1±1.02 in 12 hr group (N=7), and, 1.5±0.25 in 24hr group (N=6). Fluorescent intensity was enough to find the pulmonary neoplasm from 3 to 24 hours, and optimal time for identification of pulmonary nodule was 3 to 12 hours after low dosage of ICG injection by ICFIS (Figure).
Conclusion : This study demonstrated that optimal time for identification of pulmonary nodule was 3 to 12 hours after low dosage of ICG injection by ICFIS. This showed different result in hepatic tumor of which optimal injection time was at least 24 hours before operation. This data informed us that optimal injection time of ICG should be evaluated in each different solid organ tumor for fluorescent image guided surgery.
Methods : Twenty-eight consecutive patients who were scheduled to undergo pulmonary resection for pulmonary neoplasms were enrolled in this study. ICG (1 mg/kg) was administered intravenously prior to operation according to the time allocation. The retrieved surgical specimens were examined for signal to background ratio (SBR) using custom-built intraoperative color and fluorescence merged imaging system (ICFIS) on a back table at 3, 6, 12, and 24 hours after injection. We analyzed the fluorescence intensity and the histologic characteristics of the specimens.
Results : Patients had primary lung cancer in 20 and metastatic lung cancer in 8. ICG fluorescent imaging was observed in all patients (100%). The SBR of pulmonary neoplasm was 2.4±1.88 in 3hr group (N=7), 3.1±1.91 in 6hr group (N=8), 2.1±1.02 in 12 hr group (N=7), and, 1.5±0.25 in 24hr group (N=6). Fluorescent intensity was enough to find the pulmonary neoplasm from 3 to 24 hours, and optimal time for identification of pulmonary nodule was 3 to 12 hours after low dosage of ICG injection by ICFIS (Figure).
Conclusion : This study demonstrated that optimal time for identification of pulmonary nodule was 3 to 12 hours after low dosage of ICG injection by ICFIS. This showed different result in hepatic tumor of which optimal injection time was at least 24 hours before operation. This data informed us that optimal injection time of ICG should be evaluated in each different solid organ tumor for fluorescent image guided surgery.
책임저자: 김현구
고려대학교 의과대학 구로병원 흉부외과학교실
연락처 : 김현구, Tel: 02-2626-3106 , E-mail : kimhyunkoo@korea.a.ckr
