Indocyanine Green Fluorescence Image-guided Laparoscopic Hepatectomy Enabled Resection of a Tumor Invisible With Ultrasonography

Background: Ultrasonography (US) is widely used for pre-operative detection of liver tumors. However, US does not have high resolution and very small tumors, tumors located near the liver surface, or those in cirrhotic livers are often not detected. Case Report: A 47-year-old woman with a previous s...

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Bibliographic Details
Published in:Anticancer research 2021-08, Vol.41 (8), p.3867-3869
Main Authors: OURA, KEISUKE, AOKI, TAKESHI, TASHIRO, YOSHIHIKO, MATSUDA, KAZUHIRO, KOIZUMI, TOMOTAKE, KUSANO, TOMOKAZU, WADA, YUSUKE, SHIBATA, HIDEKI, YAMASHITA, TAKESHI, DATE, HIROMI, ARIYOSHI, TOMOTAKE, GOTO, SATORU, YAMAZAKI, KIMIYASU, WATANABE, MAKOTO, FUJIMORI, AKIRA, ENAMI, YUTA, OTSUKA, KOJI, HOFFMAN, ROBERT M., MURAKAMI, MASAHIKO
Format: Article
Language:English
Subjects:
Colon
Colon cancer
Colorectal cancer
Computed tomography
Fluorescence
Gadolinium
Hepatectomy
Laparoscopy
Liver
Liver cancer
Magnetic resonance imaging
Medical imaging
Metastases
Pseudotumors
Segments
Tumors
Ultrasonic imaging
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Summary:Background: Ultrasonography (US) is widely used for pre-operative detection of liver tumors. However, US does not have high resolution and very small tumors, tumors located near the liver surface, or those in cirrhotic livers are often not detected. Case Report: A 47-year-old woman with a previous surgery for sigmoid colon cancer (T3N1bM0 Stage3b) showed a liver tumor on the surface of segment 2 by contrast-enhanced computed tomography (CT) and gadoliniumethoxybenzyldiethlenetriaminepen-taacetic acid (Gd-EOB-DTPA) magnetic resonance imaging (MRI). However, preoperative US could not identify a tumor lesion at the same site. The most likely preoperative diagnosis was metastasis from her sigmoid colon cancer and laparoscopic liver resection was performed. Intraoperative ultrasonography (IOUS) did not identify the tumor, but it was visualized with indocyanine green (ICG) fluorescence at the surface of segment 2. Laparoscopic liver resection was performed under fluorescence guidance. Pathological examination showed a pseudotumor with negative margins. Conclusion: ICG fluorescence imaging can allow visualization of liver tumors that are undetectable on US.
ISSN:0250-7005
1791-7530
DOI:10.21873/anticanres.15180