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Annals of Surgical Oncology
Erschienen in:

05.08.2023 | Pediatric Oncology

Identification of Pediatric Tumors Intraoperatively Using Indocyanine Green (ICG)

verfasst von: Luca Pio, MD, Marc H. W. A. Wijnen, MD, Stefano Giuliani, MD, PhD, Sabine Sarnacki, MD, PhD, Andrew M. Davidoff, MD, Abdelhafeez H. Abdelhafeez, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2023

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Abstract

Background

Fluorescence-guided surgery (FGS) with indocyanine green (ICG) is increasingly applied in pediatric surgical oncology. However, FGS has been mostly reported in case studies of liver or renal tumors. Applying novel technologies in pediatric surgical oncology is more challenging than in adult surgical oncology due to differences in tumor histology, biology, and fewer cases. No consensus exists on ICG-guided FGS for surgically managing pediatric solid tumors. Therefore, we reviewed the literature and discuss the limitations and prospects of FGS.

Methods

Using PRISMA guidelines, we analyzed articles on ICG-guided FGS for childhood solid tumors. Case reports, opinion articles, and narrative reviews were excluded.

Results

Of the 108 articles analyzed, 17 (14 retrospective and 3 prospective) met the inclusion criteria. Most (70.6%) studies used ICG to identify liver tumors, but the timing and dose of ICG administered varied. Intraoperative outcomes, sensitivity and specificity, were reported in 23.5% of studies. Fluorescence-guided liver resections resulted in negative margins in 90–100% of cases; lung metastasis was detected in 33% of the studies. In otolaryngologic malignancies, positive margins without fluorescence signal were reported in 25% of cases. Overall, ICG appeared effective and safe for lymph node sampling and nephron-sparing procedures.

Conclusions

Despite promising results from FGS, ICG use varies across the international pediatric surgical oncology community. Underreported intraoperative imaging outcomes and the diversity and rarity of childhood solid tumors hinder conclusive scientific evidence supporting adoption of ICG in pediatric surgical oncology. Further international collaborations are needed to study the applications and limitations of ICG in pediatric surgical oncology.
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Metadaten
Titel
Identification of Pediatric Tumors Intraoperatively Using Indocyanine Green (ICG)
verfasst von
Luca Pio, MD
Marc H. W. A. Wijnen, MD
Stefano Giuliani, MD, PhD
Sabine Sarnacki, MD, PhD
Andrew M. Davidoff, MD
Abdelhafeez H. Abdelhafeez, MD
Publikationsdatum
05.08.2023
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 12/2023
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-13953-y

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