Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Aug;118(2):344-355.
doi: 10.1002/jso.25149. Epub 2018 Aug 11.

Intraoperative fluorescence imaging in thoracic surgery

Andrew D Newton  1 , Jarrod D Predina  1 , Shuming Nie  2 , Philip S Low  3 , Sunil Singhal  1
Affiliations
Review

Intraoperative fluorescence imaging in thoracic surgery

Andrew D Newton et al. J Surg Oncol. 2018 Aug.

Abstract

Intraoperative fluorescence imaging (IFI) can improve real-time identification of cancer cells during an operation. Phase I clinical trials in thoracic surgery have demonstrated that IFI with second window indocyanine green (TumorGlow® ) can identify subcentimeter pulmonary nodules, anterior mediastinal masses, and mesothelioma, while the use of a folate receptor-targeted near-infrared agent, OTL38, can improve the specificity for diagnosing tumors with folate receptor expression. Here, we review the existing preclinical and clinical data on IFI in thoracic surgery.

Keywords: OTL38; indocyanine green (ICG); intraoperative fluorescence imaging (IFI); near-infrared (NIR) fluorescence imaging; thoracic surgery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A) Preoperative CT scan demonstrating left lower lobe ground glass opacity. In vivo images of left lower lobe lung nodule 4 hours after 0.025 mg/kg infusion of OTL38 on B) white light, C) near-infrared light, and D) near-infrared overlay imaging. Back table images of lung wedge resection specimen on E) white light, F) near-infrared light, and G) near-infrared overlay imaging. Final pathology demonstrated a 0.6 cm adenocarcinoma in situ.
Figure 2
Figure 2
Comparison of intraoperative and back table fluorescence imaging for pulmonary adenocarcinoma with ICG, EC17, and OTL38.
Figure 3
Figure 3
A) Preoperative CT scan demonstrating an anterior mediastinal mass. In vivo images of thymoma resection 24 hours after 5 mg/kg ICG infusion on B) white light, C) near-infrared light, and D) near-infrared overlay imaging. Back table images of resected thymoma specimen with E) white light, F) near-infrared light, and G) overlay imaging. Final pathology demonstrated an encapsulated thymoma WHO type AB.
Figure 4
Figure 4
A) Preoperative CT scan demonstrating right sided pleural thickening. Back table images of resected pleural peel during pleurectomy and decortication 24 hours after 5 mg/kg ICG infusion on B) white light, C) near-infrared light, and D) overlay imaging. In vivo images of residual visceral pleural mesothelioma deposit during pleurectomy and decortication on E) white light, F) near-infrared light, and G) overlay imaging.
See this image and copyright information in PMC

References

    1. Aliperti LA, Predina JD, Vachani A, et al. Local and systemic recurrence is the Achilles heel of cancer surgery. Ann Surg Oncol. 2011;18(3):603–7. - PMC - PubMed
    1. Lohman RF, Ozturk CN, Ozturk C, et al. An Analysis of Current Techniques Used for Intraoperative Flap Evaluation. Ann Plast Surg. 2015;75(6):679–85. - PubMed
    1. Keller DS, Ishizawa T, Cohen R, et al. Indocyanine green fluorescence imaging in colorectal surgery: overview, applications, and future directions. Lancet Gastroenterol Hepatol. 2017;2(10):757–66. - PubMed
    1. Ishizawa T, Fukushima N, Shibahara J, et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer. 2009;115(11):2491–504. - PubMed
    1. van der Vorst JR, Schaafsma BE, Hutteman M, et al. Near-infrared fluorescence-guided resection of colorectal liver metastases. Cancer. 2013;119(18):3411–8. - PMC - PubMed

MeSH terms

Substances