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


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 it fluoresces when excited by near-infrared (NIR) light, it allows for imaging of the biliary system without the use of radiation and without any incisions into biliary structures. It is safe, easy to use, has low cost, and high sensitivity and contrast (Alander et al., 2012). Preliminary research with mice and pig models has shown promise in aiding correct identification of normal anatomy, as well as differentiating pathology such as CBD stones, obstructions, or leaks (Figueiredo, Nahrendorf, Vinegoni, & Weissleder, 2010; Matsui et al., 2010). "
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    ABSTRACT: A medical imaging technique known as Indocyanine Green (ICG) fluorescence cholangiography can potentially improve safety and reduce cost in minimally invasive surgery, but is not widely used. Refinement of existing ICG imaging prototypes would facilitate more widespread use of the technology. The goal of this research was to optimize the display of an ICG imaging prototype, post-hoc. Images produced by the prototype were systematically manipulated by altering brightness and contrast levels, and corresponding changes in perceived image quality were measured. Results showed that perceived image quality increased when either brightness or contrast of the original image was increased by 10% and 20%, respectively. With high quality images, similar manipulations of brightness or contrast did not improve the perceived image quality, nor did they degrade the perceived image quality significantly. These adjustments are expected to increase the overall clinical utility of the prototype as the perceived quality of the images most in need of improvement was enhanced.
    10/2014; 58(1):1726-1730. DOI:10.1177/1541931214581360
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    • "As a consequence of i)–iv), fluorescence dynamics in humans have been studied only in body-parts. The dynamic absorption and fluorescence contrast of the unspecific blood-pool tracer indocyanine green (ICG) [7], [8] have been shown to detect signs of rheumatoid arthritis [9], hemodynamic changes in diabetic feet [10], sentinel lymph nodes and lymph drainage [11]–[15], and breast cancer [16]–[20]. Feasibility studies in the brain have demonstrated that even deep tissue can be targeted [21]–[24]. "
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    ABSTRACT: Dynamic near-infrared fluorescence (DNIF) whole-body imaging of small animals has become a popular tool in experimental biomedical research. In humans, however, the field of view has been limited to body parts, such as rheumatoid hands, diabetic feet or sentinel lymph nodes. Here we present a new whole-body DNIF-system suitable for adult subjects. We explored whether this system (i) allows dynamic whole-body fluorescence imaging and (ii) can detect modulations in skin perfusion. The non-specific fluorescent probe indocyanine green (ICG) was injected intravenously into two subjects, and fluorescence images were obtained at 5 Hz. The in- and out-flow kinetics of ICG have been shown to correlate with tissue perfusion. To validate the system, skin perfusion was modulated by warming and cooling distinct areas on the chest and the abdomen. Movies of fluorescence images show a bolus passage first in the face, then in the chest, abdomen and finally in the periphery (∼10, 15, 20 and 30 seconds, respectively). When skin perfusion is augmented by warming, bolus arrives about 5 seconds earlier than when the skin is cooled and perfusion decreased. Calculating bolus arrival times and spatial fitting of basis time courses extracted from different regions of interest allowed a mapping of local differences in subcutaneous skin perfusion. This experiment is the first to demonstrate the feasibility of whole-body dynamic fluorescence imaging in humans. Since the whole-body approach demonstrates sensitivity to circumscribed alterations in skinperfusion, it may be used to target autonomous changes in polyneuropathy and to screen for peripheral vascular diseases.
    PLoS ONE 12/2013; 8(12):e83749. DOI:10.1371/journal.pone.0083749 · 3.23 Impact Factor
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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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