Indocyanine green (ICG) is a fluorescent dye used for sentinel lymph node assessment and the assessment of perfusion in skin flaps and bowel anastomoses. ICG binds serum proteins and behaves as a macromolecule in the circulation. Tumour tissue has increased vascular permeability and reduced drainage, causing macromolecules to accumulate within it. MIRRORS ICG is designed to determine whether indocyanine green (ICG) helped identify metastatic deposits in women undergoing robotic interval cytoreductive surgery for advanced-stage (3c+) ovarian cancer. Peritoneal surfaces of the abdominal and pelvic cavity were inspected under white light and near-infrared light (da Vinci Si and Xi Firefly Fluorescence imaging, Intuitive Surgical Inc.) following intravenous injection of 20 mg ICG in sterile water. Visibly abnormal areas were excised and sent to histopathology, noting IGC positivity. In total, 102 biopsies were assessed using ICG. Intravenous ICG assessment following neoadjuvant chemotherapy had a sensitivity of 91.1% (95% CI [82.6–96.4%]), a specificity of 13.0% (95% CI [2.8–33.6%]), a positive predictive value of 78.3% (95% CI [68.4–86.2%]), and a negative predictive value of 30.0% (95% CI [6.7–65.2%]) False-positive samples were seen in 9/20 patients. Psammoma bodies were noted in the histopathology reports of seven of nine of these patients with false-positive results, indicating that a tumour had been present (chemotherapy-treated disease). This study demonstrates the appearance of metastatic peritoneal deposits during robotic cytoreductive surgery following the intravenous administration of ICG in women who have undergone neoadjuvant chemotherapy for stage 3c+ advanced ovarian cancer. A perfusion assessment using indocyanine green (ICG) peritoneal angiography during robotic interval cytoreductive surgery for advanced ovarian cancer did not clinically improve metastatic disease identification in patients with high-volume disease. The use of ICG in patients with excellent response to chemotherapy where few tumour deposits remained shows some promise. The potential of molecular imaging to enhance precision surgery and improve disease identification using the robotic platform is a novel avenue for future research.
吲哚菁绿（ICG）是一种荧光染料，用于前哨淋巴结评估以及皮瓣和肠道吻合口的灌注评估。ICG与血清蛋白结合，在循环中表现为大分子。肿瘤组织具有血管通透性增加和引流减少的特点，导致大分子在其中积聚。MIRRORS ICG研究旨在确定吲哚菁绿（ICG）是否有助于识别接受机器人间歇性肿瘤细胞减灭术的晚期（3c+期）卵巢癌女性患者的转移灶。静脉注射20 mg无菌水配制的ICG后，在白光和近红外光（达芬奇Si和Xi Firefly荧光成像系统，Intuitive Surgical Inc.）下检查腹腔和盆腔的腹膜表面。切除肉眼可见的异常区域并送病理学检查，记录ICG阳性情况。总共使用ICG评估了102个活检样本。新辅助化疗后静脉注射ICG评估的敏感性为91.1%（95% CI [82.6–96.4%]），特异性为13.0%（95% CI [2.8–33.6%]），阳性预测值为78.3%（95% CI [68.4–86.2%]），阴性预测值为30.0%（95% CI [6.7–65.2%]）。在9/20的患者中观察到假阳性样本。其中9例假阳性结果患者中有7例的病理报告显示存在砂粒体，表明曾存在肿瘤（经化疗治疗的病灶）。本研究展示了接受新辅助化疗的3c+期晚期卵巢癌女性患者，在机器人肿瘤细胞减灭术中静脉注射ICG后转移性腹膜沉积物的显像情况。在晚期卵巢癌的机器人间歇性肿瘤细胞减灭术中使用吲哚菁绿（ICG）腹膜血管造影进行灌注评估，并未在临床上改善对高负荷疾病患者转移性疾病的识别。在对化疗反应良好、肿瘤沉积残留较少的患者中使用ICG显示出一定的应用前景。利用机器人平台通过分子成像技术增强精准手术并改善疾病识别，是未来研究的新方向。
肿瘤(癌症)患者之家