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Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial
Wang, Kun1,2; Huang, Weiyuan1; Chen, Xianshan3; Li, Gao3; Li, Na4; Huang, Xiuming3; Liao, Xuqiang3; Song, Jiali1; Yang, Qianyu1; He, Kunshan5; An, Yu5; Feng, Xin2; Zhang, Zeyu5; Chi, Chongwei2; Tian, Jie1,5; Chen, Fengxia3; Chen, Feng1
Source PublicationANNALS OF SURGICAL ONCOLOGY
ISSN1068-9265
2023-06-30
Pages11
Corresponding AuthorTian, Jie(jie.tian@ia.ac.cn) ; Chen, Fengxia(chenfengxia0073@126.com) ; Chen, Feng(fenger0802@163.com)
AbstractBackground. Small pulmonary nodules (<3 cm) can sometimes be unrecognizable and nonpalpable in video-assisted thoracoscopic surgery (VATS). Near-infrared fluorescence (NIF) VATS after indocyanine green (ICG) inhalation may effectively guide surgeons to locate the nodules. Objective. This study aimed to investigate the safety, feasibility, and efficacy of ICG inhalation-based NIF imaging for guiding small pulmonary nodule resections. Methods. Between February and May 2021, the first-stage, non-randomized trial enrolled 21 patients with different nodule depth, ICG inhalation doses, post-inhalation surgery times, and nodule types at a tertiary referral hospital. Between May 2021 and May 2022, the second-stage randomized trial enrolled 56 patients, who were randomly assigned to the fluorescence VATS (FLVATS) or the white-light VATS (WLVATS) group. The ratio of effective guidance and the time consumption for nodule localization were compared. Results. The first-stage trial proved this new method is safe and feasible, and established a standardized protocol with optimized nodule depth (<= 1 cm), ICG dose (0.20-0.25 mg/kg), and surgery window (50-90 min after ICG inhalation). In the second-stage trial, the FLVATS achieved 87.1% helpful nodule localization guidance, which was significantly higher than the WLVATS (59.1%, p < 0.05). The mean nodule locating time (standard deviation) was 1.8 [0.9] and 3.3 [2.3] min, respectively. Surgeons adopting FLVATS were significantly faster (p < 0.01), especially when locating small ground-glass opacities (1.3 [0.6] min vs. 7.0 [3.5] min, p < 0.05). Five of 31 nodules (16.1%) were only detectable by FLVATS, whereas both white light and palpation failed. Conclusions. This new method is safe and feasible for small pulmonary nodule resection. It significantly improves nodule localization rates with less time consumption, and hence is highly worthy for clinical promotion.
DOI10.1245/s10434-023-13753-4
WOS KeywordCELL LUNG-CANCER ; METHYLENE-BLUE ; LOCALIZATION ; IDENTIFICATION ; MANAGEMENT
Indexed BySCI
Language英语
Funding ProjectMinistry of Science and Technology of China[2017YFA0205200] ; National Natural Science Foundation of China[62027901] ; National Natural Science Foundation of China[81930053] ; National Natural Science Foundation of China[81227901] ; National Natural Science Foundation of China[92159305] ; Excellent Member Project of Youth Innovation Promotion Association CAS[2016124] ; Hainan Province Clinical Medical Center
Funding OrganizationMinistry of Science and Technology of China ; National Natural Science Foundation of China ; Excellent Member Project of Youth Innovation Promotion Association CAS ; Hainan Province Clinical Medical Center
WOS Research AreaOncology ; Surgery
WOS SubjectOncology ; Surgery
WOS IDWOS:001022111400002
PublisherSPRINGER
Citation statistics
Cited Times:1[WOS]   [WOS Record]     [Related Records in WOS]
Document Type期刊论文
Identifierhttp://ir.ia.ac.cn/handle/173211/53694
Collection中国科学院分子影像重点实验室
Corresponding AuthorTian, Jie; Chen, Fengxia; Chen, Feng
Affiliation1.Hainan Med Univ, Hainan Gen Hosp, Dept Radiol, Hainan Affiliated Hosp, Haikou, Hainan, Peoples R China
2.Chinese Acad Sci, Inst Automat, Beijing Key Lab Mol Imaging, Beijing, Peoples R China
3.Hainan Med Univ, Hainan Gen Hosp, Dept Thorac Surg, Hainan Affiliated Hosp, Haikou, Hainan, Peoples R China
4.Hainan Med Univ, Hainan Gen Hosp, Dept Anesthesiol, Affiliated Hainan Hosp, Haikou, Hainan, Peoples R China
5.Beihang Univ, Beijing Adv Innovat Ctr Big Data Based Precis Med, Sch Med & Engn, Beijing, Peoples R China
First Author AffilicationInstitute of Automation, Chinese Academy of Sciences
Recommended Citation
GB/T 7714
Wang, Kun,Huang, Weiyuan,Chen, Xianshan,et al. Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial[J]. ANNALS OF SURGICAL ONCOLOGY,2023:11.
APA Wang, Kun.,Huang, Weiyuan.,Chen, Xianshan.,Li, Gao.,Li, Na.,...&Chen, Feng.(2023).Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial.ANNALS OF SURGICAL ONCOLOGY,11.
MLA Wang, Kun,et al."Efficacy of Near-Infrared Fluorescence Video-Assisted Thoracoscopic Surgery for Small Pulmonary Nodule Resection with Indocyanine Green Inhalation: A Randomized Clinical Trial".ANNALS OF SURGICAL ONCOLOGY (2023):11.
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