The Role of Near-Infrared Fluorescence Imaging in the Assessment of Peritoneal Carcinomatosis from Colorectal Cancer

  • Gennaro GaliziaEmail author
  • Andrea Mabilia
  • Francesca Cardella
  • Annamaria Auricchio
  • Nicoletta Basile
  • Silvia Erario
  • Giovanni Del Sorbo
  • Paolo Castellano
  • Eva Lieto


Peritoneal carcinomatosis (PC) is a severe oncological condition originating from the mesothelium or, more frequently, from gastrointestinal or gynecological tumors. The PC is believed to be a terminal phase of the oncological disease and, if left untreated, has a median survival of approximately 6 months after diagnosis. PC originating from colorectal cancer is often a metachronous disease, and only 10–15% of patients with colorectal cancer show PC at the time of primary diagnosis. However, the peritoneum is involved up to 50% of cases in patients with colorectal cancer who develop tumor recurrence after potentially curative surgery of the primary tumor; and in 10–35% of cases it is the only site of tumor recurrence. The only potentially curative treatment in primary and metastatic peritoneal carcinomatosis is cytoreductive surgery associated with intraperitoneal hyperthermic chemotherapy (HIPEC) with a 5-year survival rate of 30–48%, in selected cases. One of the most critical problems in PC treatment is represented by the correct diagnosis of the peritoneal nodules and identification of smaller lesions. In recent years, new technologies have allowed surgeons to cope better with these limits. Intraoperative fluoroscopy (FI) is a recently revised imaging modality that could improve PC detection. Indocyanine green (ICG), a near-infrared contrast agent that may become fluorescent, has been shown to selectively accumulate in the tumor tissue, thus increasing diagnostic detection of PC.

This study was carried out to investigate the role of FI with ICG (ICG-FI) in the detection of peritoneal carcinomatosis from colorectal cancer.


Peritoneal carcinomatosis Fluorescence imaging Indocyanine green Peritonectomy Cytoreductive surgery Colorectal cancer Peritoneal index 

Supplementary material

Video 21.1

The video shows our experience with fluorescence imaging guided surgery with indocyanine green. Diagnosis and treatment of peritoneal carcinomatosis, HCC, and liver metastasis from colorectal cancer are shown. (MP4 13157 kb)


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Gennaro Galizia
    • 1
    Email author
  • Andrea Mabilia
    • 2
  • Francesca Cardella
    • 2
  • Annamaria Auricchio
    • 2
  • Nicoletta Basile
    • 2
  • Silvia Erario
    • 2
  • Giovanni Del Sorbo
    • 2
  • Paolo Castellano
    • 2
  • Eva Lieto
    • 2
  1. 1.Department of Translational Medical Sciences, Division of Surgical Oncology of the Gastrointestinal Tract, University of Campania ‘Luigi Vanvitelli’ – School of MedicineNaplesItaly
  2. 2.Division of Surgical Oncology of the Gastrointestinal TractUniversity of Campania “Luigi Vanvitelli”NaplesItaly

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