Indocyanine green fluorescence navigation in liver surgery: A systematic review on dose and timing of administration
(Ann Surg;IF:12.969)
- Wakabayashi T, Cacciaguerra A B, Abe Y et al. (2022) Indocyanine Green Fluorescence Navigation in Liver Surgery: A Systematic Review on Dose and Timing of Administration. Ann Surg
- CORRESPONDENCE TO : Taiga Wakabayashi MD, PhD,Department of Surgery, Isehara Kyodo Hospital, Kanagawa, Japan, 345 Tanaka, Isehara-shi, Kanagawa 259-1187, Japan; E-mail: [email protected]
Background background
Indocyanine green (ICG) fluorescence has proven to be a high potential navigation tool during liver surgery, however its optimal usage is still far from being standardized.
Indocyanine green (ICG) fluorescence has proven to be a promising navigation tool in liver surgery, but its optimal use remains to be regulated.
Methods method
A systematic review was conducted on MEDLINE/PubMed for English articles that contained the information of dose and timing of ICG administration until February 2021. Successful rates of tumor detection and liver segmentation, as well as tumor/patient background and imaging settings were also reviewed. The quality assessment of the articles was performed in accordance with the Scottish Intercollegiate Guidelines Network (SIGN).
A systematic review of English articles containing information on the dosage and timing of ICG administration up to February 2021 was conducted on MEDLINE/PubMed. Success rates for tumor detection and liver segmentation, as well as tumor/patient background and imaging settings, have also been reviewed. The quality assessment of the article was carried out in accordance with the Scottish Interscholastic Guidelines Network (SIGN).
Results results
Out of initial 311 articles, a total of 72 manuscripts were obtained. The quality assessment of the included studies revealed usually low; only 9 articles got qualified as high quality. 40 articles (55%) focused on open resections, while 32 articles (45%) on laparoscopic and robotic liver resections. 34 articles (47%) described tumor detection ability, and 25 articles (35%) did liver segmentation ability, and the others (18%) did both abilities. Negative staining was reported (42%) more than positive staining (32%). For tumor detection, majority used the dose of 0.5 mg/kg within 14 days before the operation day, and an additional administration (0.02-0.5 mg/kg) in case of longer preoperative interval. Tumor detection rate was reported to be 87.4% (range, 43%- 100%) with false positive rate reported to be 10.5% (range, 0%-31.3%). For negative staining method, the majority used 2.5 mg/body, ranging from 0.025 to 25 mg/body. For positive staining method, the majority used 0.25 mg/body, ranging from 0.025 to 12.5 mg/body. Successful segmentation rate was 88.0% (range, 53%-100%).
Of the initial 311 articles, a total of 72 manuscripts were included. Quality evaluations of the included studies were generally low; Only 9 articles qualify. 40 articles (55%) focused on open hepatectomy and 32 articles (45%) focused on laparoscopic and robotic hepatectomy. 34 articles (47 percent) described tumor detection capabilities, 25 articles (35 percent) described liver segmentation capabilities, and the remaining articles (18 percent) described both abilities. More negative staining (42%) than positive staining (32%). For the detection of tumors, most use a dose of 0.5 mg/kg within 14 days before surgery, and if the preoperative interval is long, additional administration (0.02-0.5 mg/kg) is given. Tumor detection rates were reported at 87.4% (43%-100%), and false-positive rates were reported as 10.5% (0%-31.3%). The negative method is dominated by 2.5 mg/body, ranging from 0.025 to 25 mg/body. Positive staining is based on 0.25 mg/body, ranging from 0.025 to 12.5 mg/body. Successful split rate 88.0% (range 53%-100%)
Conclusions Conclusion
The time point and dose of ICG administration strongly needs to be tailored case by case in daily practice, due to various tumor/patient backgrounds and imaging settings.
Due to different tumor/patient backgrounds and imaging settings, the timing and dosage of ICG administration need to be tailored to the specific situation in daily practice.