Optimization of Indocyanine Green for Intraoperative Fluorescent Image-Guided Localization of Lung Cancer; Analysis Based on Solid Component of Lung Nodule

Ok Hwa Jeon, Byeong Hyeon Choi, Jiyun Rho, Kyungsu Kim, Jun Hee Lee, Jinhwan Lee, Beop Min Kim, Hyun Koo Kim

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

ICG fluorescence imaging has been used to detect lung cancer; however, there is no consensus regarding the optimization of the indocyanine green (ICG) injection method. The aim of this study was to determine the optimal dose and timing of ICG for lung cancer detection using animal models and to evaluate the feasibility of ICG fluorescence in lung cancer patients. In a preclinical study, twenty C57BL/6 mice with footpad cancer and thirty-three rabbits with VX2 lung cancer were used. These animals received an intravenous injection of ICG at 0.5, 1, 2, or 5 mg/kg, and the cancers were detected using a fluorescent imaging system after 3, 6, 12, and 24 h. In a clinical study, fifty-one patients diagnosed with lung cancer and scheduled to undergo surgery were included. Fluorescent images of lung cancer were obtained, and the fluorescent signal was quantified. Based on a preclinical study, the optimal injection method for lung cancer detection was 2 mg/kg ICG 12 h before surgery. Among the 51 patients, ICG successfully detected 37 of 39 cases with a consolidation-to-tumor (C/T) ratio of >50% (TNR: 3.3 ± 1.2), while it failed in 12 cases with a C/T ratio ≤ 50% and 2 cases with anthracosis. ICG injection at 2 mg/kg, 12 h before surgery was optimal for lung cancer detection. Lung cancers with the C/T ratio > 50% were successfully detected using ICG with a detection rate of 95%, but not with the C/T ratio ≤ 50%. Therefore, further research is needed to develop fluorescent agents targeting lung cancer.

Original languageEnglish
Article number3643
JournalCancers
Volume15
Issue number14
DOIs
Publication statusPublished - 2023 Jul

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea funded by the Ministry of Education, Science, and Technology (NRF-2018R1D1A1B07048721 and NRF-2021R1I1A1A01046848).

Publisher Copyright:
© 2023 by the authors.

Keywords

  • intraoperative fluorescent image
  • localization of lung cancer
  • solid component of lung nodule

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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