title: Indocyanine Green Fluorescence Navigation Thoracoscopic Metastasectomy for Pulmonary Metastasis of Hepatocellular Carcinoma.
abstract: Indocyanine green can selectively accumulate in primary hepatocellular carcinoma (HCC) and extrahepatic metastases. We report a patient who underwent resection of pulmonary metastasis of HCC using a thoracoscopic near-infrared imaging system and fluorescent navigation surgery. A 66-year-old man with suspicion of pulmonary metastasis of HCC was referred to our hospital. Indocyanine green was injected intravenously at a dose of 0.5 mg/kg body weight, 20 h before thoracoscopic surgery. An endoscopic indocyanine green near-infrared fluorescence imaging system showed clear blue fluorescence, indicating pulmonary metastasis of HCC in a lingular segment. We performed wide wedge resection using the fluorescence image for navigation to confirm the surgical margins. The specimen was histologically confirmed as a pulmonary metastasis of HCC. In conclusion, thoracoscopic indocyanine green near-infrared fluorescence imaging for pulmonary metastases of HCC is useful in identifying tumor locations and ensuring resection margins.
authors.affiliation: Department of Thoracic, Endocrine Surgery and Oncology, Institute of Health Bioscience, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Kawakita
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Takizawa
authors.forename: Kazuya
authors.initials: K
authors.lastname: Kondo
authors.forename: Shoji
authors.initials: S
authors.lastname: Sakiyama
authors.forename: Akira
authors.initials: A
authors.lastname: Tangoku
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery*; D005456:Fluorescent Dyes / Q000008:administration & dosage*; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage*; D007275:Injections, Intravenous; D008113:Liver Neoplasms / Q000473:pathology*; D008163:Luminescent Measurements; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D000072662:Margins of Excision; D059146:Metastasectomy / Q000379:methods*; D011013:Pneumonectomy / Q000379:methods*; D011237:Predictive Value of Tests; D025321:Surgery, Computer-Assisted; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green