Indocyanine Green–Guided Nephron-Sparing Surgery for Pediatric Renal Tumors
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In brief
In brief
This retrospective study of 8 pediatric patients demonstrates that indocyanine green fluorescence can successfully guide nephron-sparing surgery for renal tumors, though with an unexpected inverse signal pattern where normal kidney tissue fluoresces more intensely than tumor tissue. Despite this counterintuitive finding, ICG-guided near infrared imaging proved feasible for real-time tumor delineation during surgery.
Written by the GCMD Library team from the article.
Background
Indocyanine green (ICG), a water-soluble tricarbocyanine fluorophore, is being increasingly used for tumor localization based on its passive intra-tumoral accumulation due to enhanced permeability and retention in tumor tissue. Therefore, we hypothesized that ICG can provide contrast to facilitate accurate, real-time recognition of renal tumors at the time of nephron-sparing surgery in children.
Methods
This retrospective study examined the feasibility of ICG in guiding nephron-sparing surgery for pediatric renal tumors.
Results
We reviewed the medical records of 8 pediatric patients with renal tumors in 12 kidneys. Intraoperative localization of tumor with near infrared guidance was successful in all 12 kidneys. However, we consistently found an inverse pattern of near infrared signal in which the normal kidney demonstrated increased fluorescent signal relative to the kidney tumor.
Conclusions
Fluorescence-guided renal tumor delineation is unique because it has an inverse pattern of near infrared signal in which the normal kidney demonstrates increased signal relative to the adjacent tumor. Nevertheless fluorescence-guided distinguishing of renal tumor from surrounding normal kidney is feasible.