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Y.H. Quan



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    P1.02 - Poster Session/ Treatment of Localized Disease – NSCLC (ID 209)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Treatment of Localized Disease - NSCLC
    • Presentations: 1
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      P1.02-021 - The Feasibility of Fluorescence Image-Guided Surgery for Pulmonary Nodules (ID 2557)

      09:30 - 17:00  |  Author(s): Y.H. Quan

      • Abstract
      • Slides

      Background:
      Recently, fluorescence imaging using indocyanine green (ICG) has been applied to cancer, not only to visualize the sentinel lymph node, but also to identify mass during surgery. We hypothesized that this fluorescence imaging will also be useful to identify and locate pulmonary nodules during surgery. We try to detect pulmonary nodules and measure fluorescence intensity by using reasonable dosage of ICG.

      Methods:
      We enrolled 11 patients who were diagnosed with a pulmonary nodule. ICG is administered intravenously at a dose of 1 mg/kg prior to operation. Surgical specimens were investigated using a near-infrared light camera system (SPY Elite) at 20 hours after injection. And we examined the histologic characteristics of the specimens.

      Results:
      Figure 1 ICG-fluorescent imaging was observed 10 out of the 11 patient. 1 squamous cell carcinoma was not detected fluorescent. 2 false – positive nodules (necrotic inflammation) were identified among the 10 fluorescent specimens. Fluorescence signal of nodules (Signal to Background Ratio (SBR)) was 4.3 ± 2.5. There was no significant difference depending on histology, size and tumor grade. However, Fluorescence signal of 2 false – positive nodules was 9.5 ± 0.7 was higher than nodules.



      Conclusion:
      This study demonstrated that fluorescence imaging using a low dosage of ICG can be useful to identify and locate pulmonary nodules during surgery. However, our results (2 false positive) also show limitation of present fluorescence image guide surgery which used only ICG for passive cancer targeting. Base on this result, we thought that for ideal fluorescence guided surgery, we will need a further study about active targeting by using biomarker as well as passive targeting. We hope that this data will give us some clue to develop fluorescence guided surgery technique in lung cancer surgery.

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