Skip to main content
SpringerLink
Log in

Navigation using indocyanine green fluorescence imaging for hepatoblastoma pulmonary metastases surgery

  • Technical Innovation
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

To achieve precise and sensitive detection of chemotherapy-resistant hepatoblastoma pulmonary metastases, we performed surgery using indocyanine green (ICG) fluorescence imaging navigation. Lung metastasectomies were performed in 10 patients aged from 1 to 11 years. ICG (0.5 mg/kg) was injected intravenously 24 h before the operation. After a thoracotomy had been performed, a 760-nm infrared ray was applied to the lung using a generator and the 830-nm evoked fluorescence was collected and visualized on a real-time display. In total, 250 fluorescence-positive lesions were extirpated in 37 operations. All of the pathologically positive lesions were clearly fluorescence positive. The diameter of the smallest detectable lesion was 0.062 mm. In two patients, there were 29 extirpated lesions that were pathologically proven not to be hepatoblastoma metastases. Although a problem of false positive remains, this method is very useful for the detection of small pulmonary metastases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. von Schweinitz D (2011) Hepatoblastoma: recent developments in research and treatment. Semin Pediatr Surg 21:21–30

    Article  Google Scholar 

  2. von Schweinitz D, Hecker H, Harms D et al (1995) Complete resection before development of drug resistance is essential for survival from advanced hepatoblastoma—a report from the German Cooperative Pediatric Liver Tumor Study HB-89. J Pediatr Surg 30:845–852

    Article  Google Scholar 

  3. Black CT, Luck SR, Musemeche CA et al (1991) Aggressive excision of pulmonary metastases is warranted in the management of childhood hepatic tumors. J Pediatr Surg 26:1082–1085

    Article  CAS  PubMed  Google Scholar 

  4. Passmore SJ, Noblett HR, Wisheart JD et al (1995) Prolonged survival following multiple thoracotomies for metastatic hepatoblastoma. Med Pediatr Oncol 24:58–60

    Article  CAS  PubMed  Google Scholar 

  5. Meyers RL, Katzenstein HM, Krailo M et al (2007) Surgical resection of pulmonary metastatic lesions in children with hepatoblastoma. J Pediatr Surg 42:2050–2056

    Article  PubMed  Google Scholar 

  6. Zsíros J, Maibach R, Shafford E et al (2010) Successful treatment of childhood high-risk hepatoblastoma with dose-intensive multiagent chemotherapy and surgery: final results of the SIOPEL-3HR study. J Clin Oncol 28:2584–2590

    Article  PubMed  Google Scholar 

  7. Hunton DB, Bollman JL, Hoffman HN (1960) Studies of hepatic function with indocyanine green. Gastroenterology 39:713–724

    CAS  PubMed  Google Scholar 

  8. Kogon B, Fernandez J, Kanter K et al (2009) The role of intraoperative indocyanine green fluorescence angiography in pediatric cardiac surgery. Ann Thorac Surg 88:632–636

    Article  PubMed  Google Scholar 

  9. Landsman ML, Kwant G, Mook GA et al (1976) Light-absorbing properties, stability, and spectral stabilization of indocyanine green. J Appl Physiol 40:575–583

    CAS  PubMed  Google Scholar 

  10. Craandijk A, Van Beek CA (1976) Indocyanine green fluorescence angiography of the choroid. Br J Ophthalmol 60:377–385

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  11. Schaafsma BE, Verbeek FP, Rietbergen DD et al (2013) Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer. Br J Surg 100:1037–1044

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Noura S, Ohue M, Seki Y et al (2010) Feasibility of a lateral region sentinel node biopsy of lower rectal cancer guided by indocyanine green using a near-infrared camera system. Ann Surg Oncol 17:144–151

    Article  PubMed  Google Scholar 

  13. Ogata F, Azuma R, Kikuchi M et al (2007) Novel lymphography using indocyanine green dye for near-infrared fluorescence labeling. Ann Plast Surg 58:652–655

    Article  CAS  PubMed  Google Scholar 

  14. Nitori N, Deguchi T, Kubota K et al (2014) Successful treatment of non-occlusive mesenteric ischemia (NOMI) using the HyperEye Medical System™ for intraoperative visualization of the mesenteric and bowel circulation: report of a case. Surg Today 44:359–362

    Article  PubMed  Google Scholar 

  15. Ishizawa T, Fukushima N, Shibahara J et al (2009) Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer 115:2491–2504

    Article  PubMed  Google Scholar 

  16. Satou S, Ishizawa T, Masuda K et al (2013) Indocyanine green fluorescent imaging for detecting extrahepatic metastasis of hepatocellular carcinoma. Gastroenterol 48:1136–1143

    Article  CAS  Google Scholar 

  17. Gotoh K, Yamada T, Ishikawa O et al (2009) A novel image-guided surgery of hepatocellular carcinoma by indocyanine green fluorescence imaging navigation. J Surg Oncol 100:75–79

    Article  PubMed  Google Scholar 

  18. Aoki T, Yasuda D, Shimizu Y et al (2008) Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection. World J Surg 32:1763–1767

    Article  PubMed  Google Scholar 

  19. Kim S, Lim YT, Soltesz EG et al (2004) Near-infrared fluorescent type II quantum dots for sentinel lymph node mapping. Nat Biotechnol 22:93–97

    Article  PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Kanagawa Children’s Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, 232-8555, Japan

    Norihiko Kitagawa, Masato Shinkai, Kyoko Mochizuki, Hidehito Usui, Hisayuki Miyagi & Kaori Nakamura

  2. Department of Pathology, Kanagawa Children’s Medical Center, Yokohama, Japan

    Mio Tanaka & Yukichi Tanaka

  3. Department of Surgery, Kushiro Rosai Hospital, Kushiro, Hokkaido, Japan

    Mitsuo Kusano

  4. Department of Oral and Maxillofacial Surgery, Kushiro Rosai Hospital, Kushiro, Hokkaido, Japan

    Seiji Ohtsubo

Authors
  1. Norihiko Kitagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masato Shinkai
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kyoko Mochizuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hidehito Usui
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hisayuki Miyagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kaori Nakamura
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mio Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yukichi Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mitsuo Kusano
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Seiji Ohtsubo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Norihiko Kitagawa.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kitagawa, N., Shinkai, M., Mochizuki, K. et al. Navigation using indocyanine green fluorescence imaging for hepatoblastoma pulmonary metastases surgery. Pediatr Surg Int 31, 407–411 (2015). https://doi.org/10.1007/s00383-015-3679-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-015-3679-y

Keywords

Search

Navigation