A Review of Indocyanine Green Fluorescent Imaging in Surgery

Department of Electrical Engineering and Energy Technology, University of Vaasa, Vaasa, Finland.
International Journal of Biomedical Imaging 04/2012; 2012(1):940585. DOI: 10.1155/2012/940585
Source: PubMed

ABSTRACT The purpose of this paper is to give an overview of
the recent surgical intraoperational applications of indocyanine
green fluorescence imaging methods, the basics of the technology,
and instrumentation used. Well over 200 papers describing this
technique in clinical setting are reviewed. In addition to the surgical
applications, other recent medical applications of ICG are briefly

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    • "Since the introduction of indocyanine green (ICG) (Scheme 1) by Fox et al. [1] [2] in 1957, ICG has gained increasing attention due to its potential for wide-spread application in various biomedical fields [3] [4] both in medical diagnostics and therapeutic treatments. Since then ICG has received approval from the FDA for a variety of different medical applications [5] [6]. Today, it is widely used as a near-infrared [7] imaging contrast agent for in vivo imaging applications. "
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    ABSTRACT: Indocyanine green (ICG) is a chemically labile compound which needs to be stabilized in aqueous media to be used in biomedical applications. In the present study, poly(ε-caprolactone) (PCL), a semi-crystalline polyester, was used to encapsulate and stabilize ICG in a hydrophobic environment. A hydrophobic and biocompatible nanocomposite was obtained by the process of encapsulating inorganic silica.ICG was embedded in the hydrophobic polymer coating by starting from a well-defined silica (Si) core of either 80 nm or 120 nm diameter, which served as a template for a ‘grafting from’ approach using ε-caprolactone. The obtained nanocomposite Si grafted PCL/ICG was based on silica nanoparticles grafted with PCL, in which ICG was adsorbed. The nanoparticles were characterized by IR spectroscopy, thermogravimetric analysis (TGA) and scanning electron microscopy (SEM). The change in the surface charge and the colloidal stability of the nanoparticles was followed by zeta potential measurements.This approach of synthesizing nanocomposite-based ICG demonstrates a new route to stabilize ICG. We synthesized biocompatible nanoparticles containing a high ICG concentration and exhibiting excellent stability to aqueous decomposition.
    Journal of Photochemistry and Photobiology A Chemistry 06/2013; 261:12–19. DOI:10.1016/j.jphotochem.2013.03.010 · 2.50 Impact Factor
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    ABSTRACT: Indocyanine green (ICG) is an FDA approved tricarbocyanine dye. This dye, with a strong absorbance in the near infrared (NIR) region, has been extensively used for fluorescence and photoacoustic imaging in vivo. ICG in its free form, however, has a few drawbacks that limit its in vivo applications, such as non-targetability, tendency to form aggregates which changes its optical properties, fast degradation, short plasma lifetime and reduced fluorescence at body temperature. In order to bypass these inherent drawbacks, we demonstrate a polyacrylamide based nanocarrier that was particularly designed to carry the negatively charged ICG molecules. These nanocarriers are biodegradable, biocompatible and can be specifically targeted to any cell or tissue. Using these nanocarriers we avoid all the problems associated with free ICG, such as degradation, aggregation and short plasma lifetime, and also enhance demonstrate its ability towards photoacoustics and fluorescence imaging.
    Proceedings of SPIE - The International Society for Optical Engineering 02/2013; DOI:10.1117/12.2002921 · 0.20 Impact Factor
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    ABSTRACT: BACKGROUND: Decreased blood perfusion at an intestinal anastomosis may contribute to postoperative anastomotic leak (AL) resulting in substantial morbidity and mortality. Near-infrared (NIR) laparoscopy in conjunction with indocyanine green (ICG) allows for visualization of the microcirculation before formation of the anastomosis, thereby allowing the surgeon to choose the point of transection at an optimally perfused area. METHODS: This is a retrospective case-control analysis examining the effectiveness of NIR + ICG in reducing the rate of AL after low anterior resection (LAR) for rectal cancer. Records of patients undergoing robot-assisted LAR for rectal cancer with and without ICG were analyzed for the years 2011 and 2012. RESULTS: Among the 40 patients who underwent robotic LAR, NIR + ICG was used in 16 cases (41 %). Male patients accounted for the majority of cases in both groups (74 %). The median level of the anastomosis was 3.5 cm in the NIR + ICG group and 5.5 cm in the control group. There was no difference in the use of diverting ileostomy. In 3 patients (19 %), the use of NIR + ICG resulted in revision of the proximal bowel (colonic) transection point before formation of the anastomosis. The distal transection point was never revised. The rate of AL in the NIR + ICG group was 6 % versus 18 % in control group. CONCLUSIONS: ICG fluorescence may play a role in anastomotic tissue perfusion assessment and affect the AL rate. Larger prospective studies are needed to further validate this novel technology.
    Surgical Endoscopy 02/2013; 27(8). DOI:10.1007/s00464-013-2832-8 · 3.31 Impact Factor
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