期刊
TRANSLATIONAL RESEARCH
卷 162, 期 5, 页码 324-331出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.trsl.2013.05.002
关键词
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资金
- Mallinckrodt Institute of Radiology Development Fund
- U.S. National Institutes of Health (NIH) (Network for Translational Research) [R01 CA171651, U54 CA136398]
- U.S. Department of Defense (DoD) Breast Cancer Research Program Predoctoral Award [W81XWH-11-1-0059]
- National Center for Research Resources [K01RR026095]
Surgical resections remain the primary curative interventions for hepatocellular carcinoma (HCC). However, lack of real-time intraoperative image guidance confines surgeons to subjective visual assessment of the surgical bed, leading to poor visualization of small positive nodules and the extension of diffuse HCC. To address this problem, we developed a wearable fluorescence imaging and display system (fluorescence goggle) for intraoperative imaging of HCCs in human patients. In this pilot study, both intravenous (IV) and transarterial hepatic (TAH) delivery of indocyanine green (ICG) were explored to facilitate fluorescence goggle-mediated HCC imaging. The results show that all primary tumors in patients (n = 4) who received TAH delivery of ICG were identified successfully by the fluorescence goggle. In addition, 6 satellite tumors were also detected by the goggle, 5 of which were neither identifiable via preoperative magnetic resonance imaging (MRI) and computed tomography (CT) nor by visual inspection and palpation. In the group (n = 5) that received ICG intravenously, only 2 of 6 tumors visible by preoperative MRI or CT were identified with the fluorescence goggle, demonstrating the limitation of this delivery route for a non-tumor-selective imaging agent. Comparative analysis shows that the HCC-to-liver florescence contrast detected by the goggle was significantly greater in patients that received TAN than IV delivery of ICG (P = 0.013). This pilot study demonstrates the feasibility of using the fluorescence goggle to identify multifocal lesion's and small tumor deposits using TAH ICG delivery in HCC patients.
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