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Intraoperative near-infrared fluorescence guided surgery using indocyanine green (ICG) may aid the surgical removal of benign bone and soft tissue tumours

Lookup NU author(s): Dr Marcus Brookes, Dr Corey ChanORCiD, Mani Ragbir, Tom Beckingsale, Dr Kenneth RankinORCiD

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Abstract

© 2024 Elsevier Ltd. Background: Benign bone and soft tissue tumours encompass a broad, heterogenous range of tumours with varying clinical characteristics. These are often managed surgically with either curettage or marginal excision, but unfortunately have high rates of local recurrence. Indocyanine green (ICG) is a fluorescent dye which can be used to identify solid malignancies intraoperatively but its use is not yet established in benign bone and soft tissue tumours. This study aims to assess whether these tumours fluoresce when administered with ICG pre-operatively and whether this helps surgeons to identify tumour intra-operatively. Patients and methods: Patients with locally aggressive benign bone and soft tissue tumours were administered with 25–75 mg of ICG preoperatively at the induction of anaesthesia. Fluorescence was imaged intraoperatively using the Stryker SPY-PHI camera. Results: Of the 12 patients included, 11 tumours fluoresced. The surgeons felt the fluorescence guided the procedure in 7 out of the 11 cases which fluoresced. It was felt to be particularly useful in the curettage of bone tumours, in which curettage could be repeated until the absence of fluorescence on imaging. After 12 months, no patients had local recurrence of the tumour. There were no adverse events recorded in this study and surgeons found the technology acceptable. Conclusions: The use of ICG for fluorescence guided surgery is a promising technology to improve outcomes of surgery for benign bone and soft tissue tumours. Further, longer term, study with a control arm is needed to identify whether it results in a reduction in the local recurrence rate.

Publication metadata

Author(s): Brookes MJ, Chan CD, Crowley TP, Ragbir M, Ghosh KM, Beckingsale T, Rankin KS

Publication type: Article

Publication status: Published

Journal: Surgical Oncology

Year: 2024

Volume: 55

Print publication date: 01/08/2024

Online publication date: 28/05/2024

Acceptance date: 27/05/2024

ISSN (print): 0960-7404

ISSN (electronic): 1879-3320

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.suronc.2024.102091

DOI: 10.1016/j.suronc.2024.102091

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