Intraoperative fluorescence imaging of lung neoplasms in near-infrared light

INTRODUCTION. In surgical treatment of early peripheral lung cancer, accurate intraoperative visualization of the tumor and determination of tumor growth boundaries remain a problem.
The OBJECTIVE was to develop a methodology and analyze the first results of intraoperative infrared fluorescence diagnosis of lung neoplasms.
METHODS AND MATERIALS. The study included 27 operated patients with lung neoplasms of various histological types. Each patient immediately after performing access, as well as on the ex vivo, underwent an attempt at fluorescence imaging of the removed tumors in the near-infrared spectrum, as well as the presence of other foci of fluorescence. The fluorescence intensity was quantified. Indocyanine green lyophilizate with Human Albumin 20 % was used as a fluorescent agent, and the MMC SCOPE ICG system was used to visualize infrared fluorescence.
RESULTS. Infrared fluorescence was used to visualize 21 out of 31 (68 %) neoplasms in 20 out of 27 (74 %) patients. When comparing fluorescent and non-fluorescent foci, there was no correlation between the presence of fluorescence and the histological structure, the size of the neoplasms and the presence of invasion of the visceral pleura. Fluorescence diagnostics also revealed in 3 patients (11 %) an additional 4 CT-negative foci ranging in size from 0.5 to 10 mm, all of which turned out to be malignant tumors.
CONCLUSION. The method of fluorescent intraoperative diagnosis is safe and informative, it allows to visualize intrapulmonary neoplasms in 74 % of patients, as well as to identify Rg-negative tumor foci in 11 % of patients.

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