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Review
. 2014;67(2):142-8.
doi: 10.5173/ceju.2014.02.art5. Epub 2014 Jun 23.

Usage of invisible near infrared light (NIR) fluorescence with indocyanine green (ICG) and methylene blue (MB) in urological oncology. Part 1

Wojciech Polom  1 , Marcin Markuszewski  1 , Young Soo Rho  2 , Marcin Matuszewski  1
Affiliations
Review

Usage of invisible near infrared light (NIR) fluorescence with indocyanine green (ICG) and methylene blue (MB) in urological oncology. Part 1

Wojciech Polom et al. Cent European J Urol. 2014.

Abstract

Introduction: Near infrared (NIR) technology has recently garnered much interest as a tool for intraoperative image-guided surgery in various surgical sub-disciplines. In urology, although nascent, NIR technology is also fostering much enthusiasm. This review discusses the two major fluorophores, indocyanine green (ICG) and methlyene blue (MB), with NIR guidance in experimental and clinical urology. The authors aim to illustrate and analyze the currently available initial studies to better understand the potential and practicability of NIR-guided imaging in the diagnosis and surgical outcome improvement. In the first part of the study we analyzed problems associated with sentinel lymph node biopsy, NIR-guided detection and imaging of tumors.

Material and methods: PubMed and Medline databases were searched for ICG and MB use in urological settings, along with data published in abstracts of urological conferences.

Results: Although NIR-guided ICG and MB are still in their initial phases, there have been significant developments in major domains of urology, including uro-oncological surgery: 1) sentinel lymph node biopsy, 2) detection and imaging of tumors.

Conclusions: Much like in other fields of surgical medicine, the application of NIR technology in urology is at its early stages. Therefore, more studies are needed to assess the true potential and limitations of the technology. However, initial developments hint towards a pioneering tool that may influence various aspects of urology.

Keywords: indocyanine green; methylene blue; near infrared fluorescence; sentinel node.

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Figures

Figure 1
Figure 1
Lymph node in case of prostate cancer seen in NIR light during surgery.
Figure 2
Figure 2
Lymph node in case of prostate cancer in white light after excision.
Figure 3
Figure 3
Lymph node in case of prostate cancer in NIR light after excision.
Figure 4
Figure 4
Bladder cancer – fluorophore ICG injection site seen in white light.
Figure 5
Figure 5
Bladder cancer – fluorophore ICG injection site seen in NIR light.
Figure 6
Figure 6
Bladder cancer – lymph node in NIR light during surgery.
Figure 7
Figure 7
Penile cancer – lymph flow in NIR light after ICG injection.
Figure 8
Figure 8
Kidney tumor seen in white light during surgery.
Figure 9
Figure 9
Kidney tumor in NIR light after intravenous ICG during surgery.
See this image and copyright information in PMC

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