Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspective

Objectives: Virtual-assisted lung mapping (VAL-MAP) is a bronchoscopic marking method of dye application on the surface of the lungs before resecting nonpalpable nodules. However, in some cases, it can be difficult to identify the markings of VAL-MAP on computed tomography and intraoperative thoraco...

Full description

Saved in:
Bibliographic Details
Main Authors: Junko Tokuno, MD, Toyofumi F. Chen-Yoshikawa, MD, PhD, Daisuke Nakajima, MD, PhD, Akihiro Aoyama, MD, PhD, Hideki Motoyama, MD, PhD, Masaaki Sato, MD, PhD, Hiroshi Date, MD, PhD
Format: Article
Language:English
Published: Elsevier 2021-12-01
Series:JTCVS Techniques
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666250721004983
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849239331202400256
author Junko Tokuno, MD
Toyofumi F. Chen-Yoshikawa, MD, PhD
Daisuke Nakajima, MD, PhD
Akihiro Aoyama, MD, PhD
Hideki Motoyama, MD, PhD
Masaaki Sato, MD, PhD
Hiroshi Date, MD, PhD
author_facet Junko Tokuno, MD
Toyofumi F. Chen-Yoshikawa, MD, PhD
Daisuke Nakajima, MD, PhD
Akihiro Aoyama, MD, PhD
Hideki Motoyama, MD, PhD
Masaaki Sato, MD, PhD
Hiroshi Date, MD, PhD
author_sort Junko Tokuno, MD
collection DOAJ
description Objectives: Virtual-assisted lung mapping (VAL-MAP) is a bronchoscopic marking method of dye application on the surface of the lungs before resecting nonpalpable nodules. However, in some cases, it can be difficult to identify the markings of VAL-MAP on computed tomography and intraoperative thoracoscopy. We developed and assessed the feasibility of indocyanine green VAL-MAP (ICG-VAL-MAP). Methods: A historical control trial was conducted to investigate the effectiveness of ICG-VAL-MAP for marking visualization compared with that of VAL-MAP. In ICG-VAL-MAP, instead of indigo carmine, ICG and computed tomography contrast agents were used for dye marking, and near-infrared fluorescence endoscopy was employed to visualize the ICG markings. The other processes in VAL-MAP were carried out. The marking visibility was assessed in 3 grades of easy, faint, or not identifiable. We compared the visibility of the markings on computed tomography images and during thoracoscopic operations between VAL-MAP (567 markings in 147 cases) and ICG-VAL-MAP (142 markings in 63 cases). Results: On the preoperative computed tomography images, ICG-VAL-MAP provided significantly better marking visualization than VAL-MAP (easy/faint/not identifiable = 142/0/0 vs 427/100/30; P < .0001). ICG-VAL-MAP provided significantly better intraoperative markings than VAL-MAP (easy/faint/not identifiable = 141/0/1, respectively, vs 475/50/42, respectively; P < .0001). Regarding complications, pneumothorax occurred in 8 (5.4%) cases of VAL-MAP and zero cases (0%) of ICG-VAL-MAP (P = .12); fever was observed in 7 (5.0%) cases of VAL-MAP and 2 (3.2%) cases of ICG-VAL-MAP (P = .72). Conclusions: ICG-VAL-MAP provided significantly better visibility of markings than VAL-MAP. It might be useful in the resection of nonpalpable small lung lesions.
format Article
id doaj-art-c7f98f096c44433c8bd127d50a22d86e
institution Kabale University
issn 2666-2507
language English
publishDate 2021-12-01
publisher Elsevier
record_format Article
series JTCVS Techniques
spelling doaj-art-c7f98f096c44433c8bd127d50a22d86e2025-08-20T04:01:02ZengElsevierJTCVS Techniques2666-25072021-12-011054254910.1016/j.xjtc.2021.07.019Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspectiveJunko Tokuno, MD0Toyofumi F. Chen-Yoshikawa, MD, PhD1Daisuke Nakajima, MD, PhD2Akihiro Aoyama, MD, PhD3Hideki Motoyama, MD, PhD4Masaaki Sato, MD, PhD5Hiroshi Date, MD, PhD6Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Thoracic Surgery, Graduate School of Medicine, Nagoya University, Nagoya, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, JapanDepartment of Thoracic Surgery, Kobe City Medical Center General Hospital, Kobe, JapanDepartment of Thoracic Surgery, Kobe City Nishi-Kobe Medical Center, Kobe, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanDepartment of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Address for reprints: Hiroshi Date, MD, PhD, Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.Objectives: Virtual-assisted lung mapping (VAL-MAP) is a bronchoscopic marking method of dye application on the surface of the lungs before resecting nonpalpable nodules. However, in some cases, it can be difficult to identify the markings of VAL-MAP on computed tomography and intraoperative thoracoscopy. We developed and assessed the feasibility of indocyanine green VAL-MAP (ICG-VAL-MAP). Methods: A historical control trial was conducted to investigate the effectiveness of ICG-VAL-MAP for marking visualization compared with that of VAL-MAP. In ICG-VAL-MAP, instead of indigo carmine, ICG and computed tomography contrast agents were used for dye marking, and near-infrared fluorescence endoscopy was employed to visualize the ICG markings. The other processes in VAL-MAP were carried out. The marking visibility was assessed in 3 grades of easy, faint, or not identifiable. We compared the visibility of the markings on computed tomography images and during thoracoscopic operations between VAL-MAP (567 markings in 147 cases) and ICG-VAL-MAP (142 markings in 63 cases). Results: On the preoperative computed tomography images, ICG-VAL-MAP provided significantly better marking visualization than VAL-MAP (easy/faint/not identifiable = 142/0/0 vs 427/100/30; P < .0001). ICG-VAL-MAP provided significantly better intraoperative markings than VAL-MAP (easy/faint/not identifiable = 141/0/1, respectively, vs 475/50/42, respectively; P < .0001). Regarding complications, pneumothorax occurred in 8 (5.4%) cases of VAL-MAP and zero cases (0%) of ICG-VAL-MAP (P = .12); fever was observed in 7 (5.0%) cases of VAL-MAP and 2 (3.2%) cases of ICG-VAL-MAP (P = .72). Conclusions: ICG-VAL-MAP provided significantly better visibility of markings than VAL-MAP. It might be useful in the resection of nonpalpable small lung lesions.http://www.sciencedirect.com/science/article/pii/S2666250721004983indocyanine greenVAL-MAPiVATS
spellingShingle Junko Tokuno, MD
Toyofumi F. Chen-Yoshikawa, MD, PhD
Daisuke Nakajima, MD, PhD
Akihiro Aoyama, MD, PhD
Hideki Motoyama, MD, PhD
Masaaki Sato, MD, PhD
Hiroshi Date, MD, PhD
Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspective
JTCVS Techniques
indocyanine green
VAL-MAP
iVATS
title Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspective
title_full Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspective
title_fullStr Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspective
title_full_unstemmed Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspective
title_short Improved visualization of virtual-assisted lung mapping by indocyanine greenCentral MessagePerspective
title_sort improved visualization of virtual assisted lung mapping by indocyanine greencentral messageperspective
topic indocyanine green
VAL-MAP
iVATS
url http://www.sciencedirect.com/science/article/pii/S2666250721004983
work_keys_str_mv AT junkotokunomd improvedvisualizationofvirtualassistedlungmappingbyindocyaninegreencentralmessageperspective
AT toyofumifchenyoshikawamdphd improvedvisualizationofvirtualassistedlungmappingbyindocyaninegreencentralmessageperspective
AT daisukenakajimamdphd improvedvisualizationofvirtualassistedlungmappingbyindocyaninegreencentralmessageperspective
AT akihiroaoyamamdphd improvedvisualizationofvirtualassistedlungmappingbyindocyaninegreencentralmessageperspective
AT hidekimotoyamamdphd improvedvisualizationofvirtualassistedlungmappingbyindocyaninegreencentralmessageperspective
AT masaakisatomdphd improvedvisualizationofvirtualassistedlungmappingbyindocyaninegreencentralmessageperspective
AT hiroshidatemdphd improvedvisualizationofvirtualassistedlungmappingbyindocyaninegreencentralmessageperspective