Intraoperative near-infrared fluorescence imaging can identify pelvic nerves in patients with cervical cancer in real time during radical hysterectomy

doi:10.1007/s00259-022-05686-z

	Intraoperative near-infrared fluorescence imaging can identify pelvic nerves in patients with cervical cancer in real time during radical hysterectomy
	He, Kunshan1,2,3,4,5 ; Li, Pengfei 6; Zhang, Zeyu 1,2; Liu, Jiaqi 6; Liu, Pan 6; Gong, Shipeng 6; Chi, Chongwei3 ; Liu, Ping 6; Chen, Chunlin 6; Tian, Jie 1,2,3
发表期刊	EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
ISSN	1619-7070
	2022-03-01
页码	9
通讯作者	Chi, Chongwei(chongwei.chi@ia.ac.cn) ; Liu, Ping(lpivy@126.com) ; Chen, Chunlin(ccl1@smu.edu.cn) ; Tian, Jie(jie.tian@ia.ac.cn)
摘要	Purpose Radical hysterectomy combined with pelvic lymphadenectomy is the standard treatment for early-stage cervical cancer, but unrecognized pelvic nerves are vulnerable to irreversible damage during surgery. This early clinical trial investigated the feasibility and safety of intraoperative near-infrared (NIR) fluorescence imaging (NIR-FI) with indocyanine green (ICG) for identifying pelvic nerves during radical hysterectomy for cervical cancer. Methods Sixty-six adults with cervical cancer were enrolled in this prospective, open-label, single-arm, single-center clinical trial. NIR-FI was performed in vivo to identify genitofemoral (GN), obturator (ON), and hypogastric (HN) nerves intraoperatively. The primary endpoint was the presence of fluorescence in pelvic nerves. Secondary endpoints were the ICG distribution in a nerve specimen and potential underlying causes of fluorescence emission in pelvic nerves. Results In total, 63 patients were analyzed. The ON was visualized bilaterally in 100% (63/63) of patients, with a mean fluorescence signal-to-background ratio (SBR) of 5.3 +/- 2.1. The GN was identified bilaterally in 93.7% (59/63) of patients and unilaterally in the remaining 4 patients, with a mean SBR of 4.1 +/- 1.9. The HN was identified bilaterally in 81.0% (51/63) of patients and unilaterally in 7.9% (5/63) of patients, with a mean SBR of 3.5 +/- 1.3. ICG fluorescence was detected in frozen sections of a nerve specimen, and was mainly distributed in axons. No ICG-related complications were observed. Conclusion This early clinical trial demonstrated the feasibility and safety of NIR-FI to visualize pelvic nerves intraoperatively. Thus, NIR-FI may help surgeons adjust surgical decision-making, avoid nerve damage, and improve surgical outcomes.
关键词	Near-infrared fluorescence imaging Indocyanine green Pelvic nerves Radical hysterectomy Cervical cancer
DOI	10.1007/s00259-022-05686-z
收录类别	SCI
语种	英语
资助项目	Ministry of Science and Technology of China[2017YFA0205200] ; Ministry of Science and Technology of China[2019YFC0120800] ; National Natural Science Foundation of China[62027901] ; National Natural Science Foundation of China[81227901] ; National Natural Science Foundation of China[81930053] ; National Natural Science Foundation of China[82001984] ; National Natural Science Foundation of China[82102236] ; National Natural Science Foundation of China[82101701] ; Chinese Academy of Sciences[QYZDJ-SSW-JSC005] ; Beijing Municipal Science & Technology Commission[Z201100006820017] ; Beijing Municipal Science & Technology Commission[Z19111000110000] ; Project of High-Level Talents Team Introduction in Zhuhai City[HLHPTP201703] ; Basic and Applied Basic Research Fund of Guangdong Province[2019A1515110337] ; Basic and Applied Basic Research Fund of Guangdong Province[2021A1515010813] ; Guangdong Medical Science and Technology Research Fund Project[A2020077] ; Nanfang Hospital President Fund[2019C005]
项目资助者	Ministry of Science and Technology of China ; National Natural Science Foundation of China ; Chinese Academy of Sciences ; Beijing Municipal Science & Technology Commission ; Project of High-Level Talents Team Introduction in Zhuhai City ; Basic and Applied Basic Research Fund of Guangdong Province ; Guangdong Medical Science and Technology Research Fund Project ; Nanfang Hospital President Fund
WOS研究方向	Radiology, Nuclear Medicine & Medical Imaging
WOS类目	Radiology, Nuclear Medicine & Medical Imaging
WOS记录号	WOS:000762898800003
出版者	SPRINGER
七大方向——子方向分类	医学影像处理与分析
引用统计	被引频次：11[WOS] [WOS记录] [WOS相关记录]
文献类型	期刊论文
条目标识符	http://ir.ia.ac.cn/handle/173211/47958
专题	中国科学院分子影像重点实验室
通讯作者	Chi, Chongwei; Liu, Ping; Chen, Chunlin; Tian, Jie
作者单位	1.Beihang Univ, Beijing Adv Innovat Ctr Big Data Based Precis Med, Sch Engn Med, Beijing 100191, Peoples R China 2.Beihang Univ, Key Lab Big Data Based Precis Med, Minist Ind & Informat Technol, Beijing 100191, Peoples R China 3.Chinese Acad Sci, Inst Automat, CAS Key Lab Mol Imaging, State Key Lab Management & Control Complex Syst, Beijing 100190, Peoples R China 4.Chinese Acad Sci, Inst Software, State Key Lab Comp Sci, Beijing, Peoples R China 5.Chinese Acad Sci, Inst Software, Beijing Key Lab Human Comp Interact, Beijing, Peoples R China 6.Southern Med Univ, Nanfang Hosp, Dept Obstet & Gynecol, Guangzhou, Peoples R China
第一作者单位	中国科学院自动化研究所
通讯作者单位	中国科学院自动化研究所
推荐引用方式 GB/T 7714	He, Kunshan,Li, Pengfei,Zhang, Zeyu,et al. Intraoperative near-infrared fluorescence imaging can identify pelvic nerves in patients with cervical cancer in real time during radical hysterectomy[J]. EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING,2022:9.
APA	He, Kunshan.,Li, Pengfei.,Zhang, Zeyu.,Liu, Jiaqi.,Liu, Pan.,...&Tian, Jie.(2022).Intraoperative near-infrared fluorescence imaging can identify pelvic nerves in patients with cervical cancer in real time during radical hysterectomy.EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING,9.
MLA	He, Kunshan,et al."Intraoperative near-infrared fluorescence imaging can identify pelvic nerves in patients with cervical cancer in real time during radical hysterectomy".EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING (2022):9.