Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological Teams

ABSTRACT Introduction Despite advances in lung cancer management, it remains the leading cause of cancer‐related deaths. Low‐dose computed tomography (LDCT) screening has increased detection of small, difficult‐to‐palpate lung lesions. Materials and Methods This retrospective study at Chang Gung Mem...

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Main Authors: Ching Feng Wu, Kuei An Chen, Ming Ju Hsieh, Yu Fu Wu, Tzu Yi Yang, Ching Yang Wu
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Thoracic Cancer
Subjects:
Online Access:https://doi.org/10.1111/1759-7714.70139
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author Ching Feng Wu
Kuei An Chen
Ming Ju Hsieh
Yu Fu Wu
Tzu Yi Yang
Ching Yang Wu
author_facet Ching Feng Wu
Kuei An Chen
Ming Ju Hsieh
Yu Fu Wu
Tzu Yi Yang
Ching Yang Wu
author_sort Ching Feng Wu
collection DOAJ
description ABSTRACT Introduction Despite advances in lung cancer management, it remains the leading cause of cancer‐related deaths. Low‐dose computed tomography (LDCT) screening has increased detection of small, difficult‐to‐palpate lung lesions. Materials and Methods This retrospective study at Chang Gung Memorial Hospital (2014–2022) evaluated the feasibility of image‐guided segmentectomy (I‐segmentectomy) using indocyanine green (ICG) for lesion localization and intersegmental plane navigation. Results A total of 260 patients with 266 pulmonary lesions were enrolled in the study cohort, with 122 lesions undergoing image‐guided segmentectomy (I‐segmentectomy). After propensity score matching, lesions resected using the I‐segmentectomy method provided appropriate resection margins and margin‐to‐tumor ratios, particularly for lesions larger than 1 cm. Additionally, operation times were shorter with I‐segmentectomy. Survival analysis showed no significant differences in disease‐free and overall survival; although I‐segmentectomy maintained a 100% survival rate. Conclusion Overall, I‐segmentectomy with dual ICG fluorescence imaging is a feasible, safe, and effective method for ensuring adequate resection margins in difficult‐to‐discern lung lesions. Further prospective studies are necessary to validate these findings and assess long‐term outcomes.
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spelling doaj-art-4f5f481d2bb2471fb9d9a8d378900ff02025-08-20T04:01:02ZengWileyThoracic Cancer1759-77061759-77142025-08-011615n/an/a10.1111/1759-7714.70139Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological TeamsChing Feng Wu0Kuei An Chen1Ming Ju Hsieh2Yu Fu Wu3Tzu Yi Yang4Ching Yang Wu5College of Medicine, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital Chang Gung University Linkou TaiwanDepartment of Medical Imaging and Intervention, Chang Gung Memorial Hospital Chang Gung University Linkou TaiwanCollege of Medicine, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital Chang Gung University Linkou TaiwanDepartment of Medical Imaging and Intervention, Chang Gung Memorial Hospital Chang Gung University Linkou TaiwanCollege of Medicine, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital Chang Gung University Linkou TaiwanCollege of Medicine, Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital Chang Gung University Linkou TaiwanABSTRACT Introduction Despite advances in lung cancer management, it remains the leading cause of cancer‐related deaths. Low‐dose computed tomography (LDCT) screening has increased detection of small, difficult‐to‐palpate lung lesions. Materials and Methods This retrospective study at Chang Gung Memorial Hospital (2014–2022) evaluated the feasibility of image‐guided segmentectomy (I‐segmentectomy) using indocyanine green (ICG) for lesion localization and intersegmental plane navigation. Results A total of 260 patients with 266 pulmonary lesions were enrolled in the study cohort, with 122 lesions undergoing image‐guided segmentectomy (I‐segmentectomy). After propensity score matching, lesions resected using the I‐segmentectomy method provided appropriate resection margins and margin‐to‐tumor ratios, particularly for lesions larger than 1 cm. Additionally, operation times were shorter with I‐segmentectomy. Survival analysis showed no significant differences in disease‐free and overall survival; although I‐segmentectomy maintained a 100% survival rate. Conclusion Overall, I‐segmentectomy with dual ICG fluorescence imaging is a feasible, safe, and effective method for ensuring adequate resection margins in difficult‐to‐discern lung lesions. Further prospective studies are necessary to validate these findings and assess long‐term outcomes.https://doi.org/10.1111/1759-7714.70139image‐guided segmentectomylung cancerresection marginuniportal VATS
spellingShingle Ching Feng Wu
Kuei An Chen
Ming Ju Hsieh
Yu Fu Wu
Tzu Yi Yang
Ching Yang Wu
Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological Teams
Thoracic Cancer
image‐guided segmentectomy
lung cancer
resection margin
uniportal VATS
title Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological Teams
title_full Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological Teams
title_fullStr Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological Teams
title_full_unstemmed Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological Teams
title_short Feasibility, Safety, and Early Outcomes of Image‐Guided Segmentectomy Using Near‐Infrared Fluorescence Dye for Tumor Visualization and Margin Identification: A Collaborative Effort by the Surgical and Radiological Teams
title_sort feasibility safety and early outcomes of image guided segmentectomy using near infrared fluorescence dye for tumor visualization and margin identification a collaborative effort by the surgical and radiological teams
topic image‐guided segmentectomy
lung cancer
resection margin
uniportal VATS
url https://doi.org/10.1111/1759-7714.70139
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