Abstract
Reports detailing microscopic observations of indocyanine green (ICG) fluorescence imaging (IFI) in hepatocellular carcinoma (HCC) and metastatic liver cancer are rare. We were able to perform microscopic IFI results in postoperative paraffin-embedded tissue samples from liver tumors. Methods: Between April 2010 and March 2014, 19 patients with HCC or liver metastases of colorectal tumors underwent liver resection. ICG solution was injected into the peripheral vein from 14 to 2 days prior to operation. After operation, we microscopically performed tissue section IFI using a fluorescence microscope with a near-infrared cube. Results: We observed that IFI characteristics depended on tumor type microscopically. In normal liver tissue, fluorescence consistent with a capillary bile cavity was observed. HCC generally had heterogeneous IFI. Well- or moderately differentiated HCC showed cytoplasmic fluorescence as observed by ICG fluorescence microscopy. Furthermore, poorly and unknown differentiated HCC except one case showed nuclear fluorescence in cancer cells and cytoplasmic fluorescence in the surrounding noncancer cells. In metastatic carcinoma, we observed that non-tumor cells in the marginal region and tumor cells in the central region did not fluoresce. Conclusions: We suggest that the variations in ICG fluorescence imaging patterns may reflect different tumor characteristics. ICG fluorescence in paraffin-embedded tissue samples is preserved in the long term.
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References
Tanaka E, Choi HS, Fujii H, Bawendi MG, Frangioni JV (2006) Image-guided oncologic surgery using invisible light: completed pre-clinical development for sentinel lymph node mapping. Ann Surg Oncol 13:1671–1681
Kitai T, Inamoto T, Miwa M, Shikayama T (2005) Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer patients. Breast Cancer 12:211–215
Kusano M, Tajima Y, Yamazaki K, Kato M, Watanabe M, Miwa M (2008) Sentinel nodemapping guided by indocyanine green fluorescence imaging: a new method for sentinel node navigation surgery in gastrointestinal cancer. Dig Surg 25:103–108
Tajima Y, Yamazaki K, Masuda Y et al (2009) Sentinel node mapping guided by indocyanine green fluorescence imaging in gastric cancer. Ann Surg 249:58–62
Parungo CP, Ohnishi S, Kimu SW et al (2005) Intraoperative identification of esophageal sentinel lymph nodes with near-infrared fluorescence imaging. J Thorac Cardiovasc Surg 129:844–850
Rubens FD, Ruel M, Fremes SE (2002) A new and simplified method for coronary and graft imaging during CABG. Heart Surg Forum 5:141–144
Aoki T, Yasuda D, Shimizu Y et al (2008) Image-guided liver mapping using fluorescence navigation system with indocyanine green for anatomical hepatic resection. World J Surg 32:1763–1767
Uchiyama K, Ueno M, Ozawa S et al (2011) Combined intraoperative use of contrast-enhanced ultrasonography imaging using a sonazoid and fluorescence navigation system with indocyanine green during anatomical hepatectomy. Langenbecks Arch Surg 396:1101–1107
Ishizawa T, Tamura S, Masuda K et al (2009) Intraoperative fluorescent cholangiography using indocyanine green: a biliary road map for safe surgery. J Am Coll Surg 208:e1–e4
Ishizawa T, Fukushima N, Shibahara J et al (2009) Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer 115:2491–2504
Morita Y, Sakaguchi T, Unno N et al (2013) Detection of hepatocellular carcinomas with near-infrared fluorescence imaging using indocyanine green: its usefulness and limitation. Int J Clin Oncol 18:232–241
Yokoyama N, Otani T, Hashidate H et al (2012) Real-time detection of hepatic micrometastases from pancreatic cancer by intraoperative fluorescence imaging. Cancer 118:2813–2819
van der Vorst JR, Schaafsma BE, Hutteman M et al (2013) Near-infrared fluorescence-guided resection of colorectal liver metastases. Cancer 119:3411–3418
Kanematsu T, Furui J, Yanaga K, Okudaira S, Shimada M, Shirabe K (2002) A 16-year experience in performing hepatic resection in 303 patients with hepatocellular carcinoma: 1985–2000. Surgery 131:s153–s158
Yaseen MA, Yu J, Wong MS, Anvari B (2008) In-vivo fluorescence imaging of mammalian organs using charge-assembled mesocapsule constructs containing indocyanine green. Opt Express 16:20577–20587
Stieger B, Heger M, Graaf W, Paumgartner G, Gulik T (2012) The emerging role of transport systems in liver function tests. Eur J Pharmacol 675:1–5
Sathirakul K, Suzuki H, Yasuda K et al (1993) Kinetic analysis of hepatobiliary transport of organic anions in Eisai hyperbilirubinemic mutant rats. J Pharmacol Exp Ther 265:1301–1312
Ishizawa T, Masuda K, Urano Y et al (2014) Mechanistic background and clinical applications of indocyanine green fluorescence imaging of hepatocellular carcinoma. Ann Surg Oncol 21:440–448
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Shimada, S., Ohtsubo, S., Kusano, M. (2016). Microscopic Findings of Fluorescence of Liver Cancers. In: Kusano, M., Kokudo, N., Toi, M., Kaibori, M. (eds) ICG Fluorescence Imaging and Navigation Surgery. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55528-5_28
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DOI: https://doi.org/10.1007/978-4-431-55528-5_28
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