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Intraoperative Near-infrared Fluorescence (NIR) Imaging With Indocyanine Green (ICG) Can Identify Bone and Soft Tissue Sarcomas which May Provide Guidance for Oncological Resection

Lookup NU author(s): Dr Fabio Nicoli, Daniel Saleh, Dr Corey ChanORCiD, Tom Beckingsale, Dr Kenneth RankinORCiD


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Background: Complete excision of sarcomas to maximize function without compromising the oncological outcome can be challenging. The aim of this study was to investigate the feasibility and potential drawbacks of near-infrared (NIR) fluorescence imaging with indocyanine green during resection of bone and soft tissue sarcomas. Methods: Eleven patients with high-grade sarcomas were enrolled in the study. All patients received intravenous indocyanine green (75 mg) between 16 and 24 hours before the resection. Sarcomas were resected under NIR guidance and specimens were sent for routine histopathological analysis. Results: Majority of treatment naive tumors demonstrated fluorescence. There were no adverse events from the indocyanine green administration. In 3 cases, the fluorescence was reported by the surgeon to have been of definite guidance leading to further tissue resection to improve the margin. Conclusion: This is the first report of NIR fluorescence guidance in the setting of open sarcoma surgery. The technique is acceptable to patients and surgeons and was able to guide resection. Multicenter studies are required to assess the utility of this technique in a large cohort of patients with regards to quantification of fluorescence, resection guidance, and longer follow-up period.

Publication metadata

Author(s): Nicoli F, Saleh DB, Baljer B, Chan CD, Beckingsale T, Ghosh KM, Ragbir M, Rankin KS

Publication type: Article

Publication status: Published

Journal: Annals of Surgery

Year: 2021

Volume: 273

Issue: 2

Pages: e63-e68

Print publication date: 01/02/2021

Online publication date: 27/03/2020

Acceptance date: 03/02/2020

ISSN (print): 0003-4932

ISSN (electronic): 1528-1140

Publisher: Lippincott, Williams and Wilkins


DOI: 10.1097/SLA.0000000000003857


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