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首页> 外文期刊>Translational research: the journal of laboratory and clinical medicine >First in-human intraoperative imaging of HCC using the fluorescence goggle system and transarterial delivery of near-infrared fluorescent imaging agent: A pilot study
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First in-human intraoperative imaging of HCC using the fluorescence goggle system and transarterial delivery of near-infrared fluorescent imaging agent: A pilot study

机译：首次使用荧光镜系统对人肝癌进行术中HCC成像，并经动脉输送近红外荧光显像剂：一项初步研究

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Surgical resections remain the primary curative interventions for hepatocellular carcinoma (HCC). However, lack of real-time intraoperative image guidance confines surgeons to subjective visual assessment of the surgical bed, leading to poor visualization of small positive nodules and the extension of diffuse HCC. To address this problem, we developed a wearable fluorescence imaging and display system (fluorescence goggle) for intraoperative imaging of HCCs in human patients. In this pilot study, both intravenous (IV) and transarterial hepatic (TAH) delivery of indocyanine green (ICG) were explored to facilitate fluorescence goggle-mediated HCC imaging. The results show that all primary tumors in patients (n = 4) who received TAH delivery of ICG were identified successfully by the fluorescence goggle. In addition, 6 satellite tumors were also detected by the goggle, 5 of which were neither identifiable via preoperative magnetic resonance imaging (MRI) and computed tomography (CT) nor by visual inspection and palpation. In the group (n = 5) that received ICG intravenously, only 2 of 6 tumors visible by preoperative MRI or CT were identified with the fluorescence goggle, demonstrating the limitation of this delivery route for a non-tumor-selective imaging agent. Comparative analysis shows that the HCC-to-liver florescence contrast detected by the goggle was significantly greater in patients that received TAH than IV delivery of ICG (P = 0.013). This pilot study demonstrates the feasibility of using the fluorescence goggle to identify multifocal lesions and small tumor deposits using TAH ICG delivery in HCC patients.
机译：手术切除仍是肝细胞癌（HCC）的主要治疗手段。但是，由于缺乏实时的术中图像引导，外科医生只能对手术床进行主观视觉评估，从而导致小阳性结节的可视性较差以及弥漫性HCC的扩大。为了解决这个问题，我们开发了一种可穿戴式荧光成像和显示系统（荧光护目镜），用于人类患者肝癌的术中成像。在该初步研究中，研究了吲哚菁绿（ICG）的静脉内（IV）和经动脉肝（TAH）递送，以促进荧光镜介导的HCC成像。结果表明，通过荧光镜成功鉴定了接受TAH递送ICG的患者（n = 4）中的所有原发肿瘤。另外，通过护目镜还检测到6个卫星肿瘤，其中5个既不能通过术前磁共振成像（MRI）和计算机断层扫描（CT）来识别，也不能通过视觉检查和触诊来识别。在静脉内接受ICG的组（n = 5）中，术前MRI或CT可见的6个肿瘤中只有2个被荧光镜识别，表明该传递途径对非肿瘤选择性显像剂的局限性。对比分析表明，在接受TAH的患者中，通过护目镜检测到的HCC与肝脏荧光对比显着大于经IVG递送的ICG（P = 0.013）。这项先导研究证明了使用荧光镜在HCC患者中通过TAH ICG递送识别多灶性病变和小肿瘤沉积物的可行性。

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