Method for Real-Time Tissue Quantification of Indocyanine Green Revealing Optimal Conditions for Near Infrared Fluorescence Guided Surgery

Near infrared fluorescence guided surgery (NIRFGS) offers better distinction between cancerous and normal tissues compared to surgeries relying on a surgeon’s senses of sight and touch. Because of the greater accuracy in determining tumor tissue margins, NIRFGS within clinics continues to grow. Howe...

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Published inAnalytical chemistry (Washington) Vol. 90; no. 13; pp. 7922 - 7929
Main Authors Wang, Ziyang, Ni, Kena, Zhang, Xudong, Ai, Shichao, Guan, Wenxian, Cai, Huiming, Wang, Yiqing, Lu, Qian, Lane, Lucas A
Format Journal Article
LanguageEnglish
Published United States American Chemical Society 03.07.2018
Subjects
Analytical chemistry
Animals
Cell Line, Tumor
Chemistry
Fluorescence
Indocyanine Green - metabolism
Infrared imaging systems
Infrared Rays
Injections
Mice
Optical Imaging
Real time
Standardization
Surgery
Surgery, Computer-Assisted - methods
Time Factors
Tissues
Tumors
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Summary:Near infrared fluorescence guided surgery (NIRFGS) offers better distinction between cancerous and normal tissues compared to surgeries relying on a surgeon’s senses of sight and touch. Because of the greater accuracy in determining tumor tissue margins, NIRFGS within clinics continues to grow. However, NIRFGS lacks standardization of the indocyanine green (ICG) dose and the preoperative period allowed after ICG administration. In an aim to find optimal doses and preoperative periods for NIRFGS standardization, we developed a method that quantitatively determines ICG levels within tissues in real-time. We find that not only do the dose and the preoperative periods influence tumor-to-background ratios (TBRs), but both also heavily influence subject-to-subject variances of these ratios. Optimal detection conditions are observed when larger than typical ICG doses are administered and longer than typical preoperative periods are allowed. Larger doses lead to increased TBRs, but longer preoperative periods are necessary to reduce TBR variances to those observed when using smaller doses. Our results suggest that a clinical investigation into maximum tolerable ICG doses and prolonging preoperative periods in NIRFGS is warranted.
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ISSN:0003-2700
1520-6882
DOI:10.1021/acs.analchem.8b00480