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The Efficacy and Safety of an Indocyanine Green-Macroaggregated Albumin-Hyaluronic Acid Mixture (LuminoMark™) for Surgical Localization of Recurrent Thyroid Cancer

  • Endocrine Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The recurrence of thyroid cancer poses challenges compounded by postoperative fibrosis and anatomic changes. By overcoming the limitations of current localizing dye techniques, indocyanine green-macroaggregated albumin-hyaluronic acid (ICG-MAA-HA) mixture dye promises improved localization. This study aimed to evaluate the efficacy and safety of the dye for recurrent thyroid cancer.

Methods

The nine patients in this study underwent surgery and postoperative ultrasonography. The dye was injected into recurrent lesions in all the patients preoperatively. During surgery, the lesions were confirmed with an imaging system before and after excision. If the lesion was unidentifiable with the naked eye, surgical excision was performed under the corresponding fluorescent guide. Side effects related to the dye injection and completeness of the surgery were evaluated.

Results

No side effects such as bleeding, skin tattooing, or pain during or after the dye injection were reported, and no discoloration occurred that interfered with the surgical field of view during surgery. In three cases (33.3 %), because it was difficult to localize metastatic lesions with the naked eye, the operation was successfully completed using an imaging system. The completeness of the surgical resection was confirmed by ultrasonography after an average of 5 months postoperatively.

Conclusion

The study found that ICG-MAA-HA dye effectively located metastatic and recurrent thyroid cancer and had favorable results in terms of minimal procedural side effects and potential for assisting the surgeon. A large-scale multi-institutional study is necessary to prove the clinical significance regarding patient survival and disease control.

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Data Availability

Unavailable because informed consent for sharing patient personal information was not obtained.

References

  1. Nguyen QT, Lee EJ, Huang MG, Park YI, Khullar A, Plodkowski RA. Diagnosis and treatment of patients with thyroid cancer. Am Health Drug Benefits. 2015;8:30.

    PubMed  PubMed Central  Google Scholar 

  2. Zhao W, You L, Hou X, et al. The effect of prophylactic central neck dissection on locoregional recurrence in papillary thyroid cancer after total thyroidectomy: a systematic review and meta-analysis: pCND for the locoregional recurrence of papillary thyroid cancer. Ann Surg Oncol. 2017;24:2189–98.

    Article  PubMed  Google Scholar 

  3. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mitchell A, Gandhi A, Scott-Coombes D, Perros P. Management of thyroid cancer: United Kingdom national multidisciplinary guidelines. J Laryngol Otol. 2016;130:S150–60.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Viola D, Elisei R. Management of medullary thyroid cancer. Endocrinol Metabol Clin. 2019;48:285–301.

    Article  Google Scholar 

  6. Kim MK, Mandel SH, Baloch Z, et al. Morbidity following central compartment reoperation for recurrent or persistent thyroid cancer. Arch Otolaryngol Head Neck Surg. 2004;130:1214–6.

    Article  PubMed  Google Scholar 

  7. Ahn D, Sohn JH, Kim H. Surgeon-performed intraoperative tumor localization in recurrent papillary thyroid carcinoma by ultrasound-guided intratumoral indigo carmine injection. World J Surg. 2014;38:1995–2001.

    Article  PubMed  Google Scholar 

  8. Hartl DM, Chami L, Ghuzlan AA, et al. Charcoal suspension tattoo localization for differentiated thyroid cancer recurrence. Ann Surg Oncol. 2009;16:2602–8.

    Article  PubMed  Google Scholar 

  9. Kim I, Choi HJ, Ryu JM, et al. The efficacy and safety of indocyanine green-hyaluronic acid mixture (LuminoMark™) for localization in patients with non-palpable breast lesions: a multi-center open-label parallel phase 2 clinical trial. BMC Surg. 2021;21:1–9.

    Article  CAS  Google Scholar 

  10. Bang YJ, Choi HJ, Kim I, et al. The efficacy and safety of an indocyanine green–hyaluronic acid mixture (LuminoMark™) for localization in patients with non-palpable breast lesions: a multicenter, randomized, open-label, parallel phase 3 clinical trial. Front Oncol. 2023;13:1039670.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Lee E-G, Kim S-K, Han JH, Lee D-E, Jung S-Y, Lee S. Surgical outcomes of localization using indocyanine green fluorescence in breast-conserving surgery: a prospective study. Sci Rep. 2021;11:9997.

    Article  CAS  PubMed  PubMed Central  ADS  Google Scholar 

  12. Chami L, Hartl D, Leboulleux S, et al. Preoperative localization of neck recurrences from thyroid cancer: charcoal tattooing under ultrasound guidance. Thyroid. 2015;25:341–6.

    Article  PubMed  Google Scholar 

  13. Soprani F, De Vito A, Bondi F, et al. Preoperative charcoal suspension tattoo for the detection of differentiated thyroid cancer recurrence. Mol Clin Oncol. 2019;10:524–30.

    PubMed  PubMed Central  Google Scholar 

  14. Yi X, Wang F, Qin W, Yang X, Yuan J. Near-infrared fluorescent probes in cancer imaging and therapy: an emerging field. Int J Nanomed. 2014:1347–65

  15. Fanaropoulou NM, Chorti A, Markakis M, Papaioannou M, Michalopoulos A, Papavramidis T. The use of indocyanine green in endocrine surgery of the neck: a systematic review. Medicine. 2019;98:e14765.

  16. Pleijhuis R, Langhout G, Helfrich W, et al. Near-infrared fluorescence (NIRF) imaging in breast-conserving surgery: assessing intraoperative techniques in tissue-simulating breast phantoms. Eur J Surg. 2011;37:32–9.

    Article  CAS  Google Scholar 

  17. van der Vorst JR, Schaafsma BE, Hutteman M, et al. Near-infrared fluorescence-guided resection of colorectal liver metastases. Cancer. 2013;119:3411–8.

    Article  PubMed  Google Scholar 

  18. Jung Y-S, Kim S-k, Park I, et al. Surgical targeting of recurrent thyroid cancer using a novel mixture of 99m-technetium macroaggregated albumin and indocyanine green. Surg Innov. 2014;21:622–9.

    Article  PubMed  Google Scholar 

  19. Iyer NG, Kumar A, Nixon IJ, et al. Incidence and significance of Delphian node metastasis in papillary thyroid cancer. Ann Surg. 2011;253:988–91.

    Article  PubMed  Google Scholar 

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Acknowledgment

This study was supported by National Cancer Center Grants, Republic of Korea (NCC2310622 and NCC2212460-1).

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Author notes

  1. Seok-ki Kim and Jungirl Seok have contributed equally as co-first authors.

Authors and Affiliations

  1. Department of Nuclear Medicine, National Cancer Center, Goyang, Republic of Korea

    Seok-ki Kim MD, PhD, Sohyun Park MD, PhD & Tae Sung Kim MD, PhD

  2. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Republic of Korea

    Jungirl Seok MD, PhD

  3. Department of Radiology, National Cancer Center, Goyang, Republic of Korea

    Chang Yoon Lee MD

  4. Department of Otorhinolaryngology–Head and Neck Surgery, National Cancer Center, Goyang, Republic of Korea

    Chang Hwan Ryu MD, PhD, Sung Yong Choi MD, PhD, Junsun Ryu MD, PhD & Yuh-Seog Jung MD, PhD

  5. Department of Pathology, National Cancer Center, Goyang, Republic of Korea

    Seog Yun Park MD, PhD

  6. Department of Internal Medicine, National Cancer Center, Goyang, Republic of Korea

    Young Ki Lee MD, Yul Hwangbo MD, PhD, Eun Kyung Lee MD, PhD & You Jin Lee MD, PhD

  7. Department of Radiation Oncology, National Cancer Center, Goyang, Republic of Korea

    Tae Hyun Kim MD, PhD

Authors
  1. Seok-ki Kim MD, PhD
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  2. Jungirl Seok MD, PhD
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  7. Young Ki Lee MD
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  11. Sohyun Park MD, PhD
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  12. Tae Sung Kim MD, PhD
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  15. Yuh-Seog Jung MD, PhD
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Contributions

Study concept and design: SKK, YSJ Data acquisition: CYL, CHR, SYC, SYP, YKL, YH, EKL, YJL, SP, TSK, THK Data analysis and interpretation: JS Article preparation: SKK, JS Article editing: all authors. Final approval: all authors.

Corresponding author

Correspondence to Yuh-Seog Jung MD, PhD.

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Disclosure

Seok-ki Kim is the primary inventor of the domestically patented indocyanine green-macroaggregated-hyaluronic acid mixture. The remaining authors have no conflicts of interest.

Ethical approval

The study protocol was reviewed and approved by the Institutional Review Board of the National Cancer Center, which granted a waiver of informed consent due to the retrospective design of the study (IRB No. NCC2020-0228). The study was registered on cris.nih.go.kr (Identifier: KCT0008577).

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Kim, Sk., Seok, J., Lee, C.Y. et al. The Efficacy and Safety of an Indocyanine Green-Macroaggregated Albumin-Hyaluronic Acid Mixture (LuminoMark™) for Surgical Localization of Recurrent Thyroid Cancer. Ann Surg Oncol 31, 2349–2356 (2024). https://doi.org/10.1245/s10434-023-14831-3

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  • DOI: https://doi.org/10.1245/s10434-023-14831-3

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