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...
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Elsevier
2021-12-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250721004983 |
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| 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 |
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