• Ya-Min Zhang, Rui Shi, Jian-Cun Hou, Zi-Rong Liu, Zi-Lin Cui, Yang Li, Di Wu, Yuan Shi, and Zhong-Yang Shen.
• Department of Hepatobiliary Surgery, First Central Hospital, No. 24 Fukang Road, Nankai District, Tianjin, 300192, China. zhangyanminzym@126.com.
• J. Cancer Res. Clin. Oncol. 2017 Jan 1; 143 (1): 51-58.

PurposeClear delineation between tumors and normal tissues is ideal for real-time surgical navigation imaging. We investigated applying indocyanine green (ICG) fluorescence imaging navigation using an intraoperative administration method in liver resection.MethodsFifty patients who underwent liver resection were divided into two groups based on clinical situation and operative purpose. In group I, sizes of superficial liver tumors were determined; tiny tumors were identified. In group II, the liver resection margin was determined; real-time navigation was performed. ICG was injected intravenously at the beginning of the operation; the liver surface was observed with a photodynamic eye (PDE).ResultsLiver resection margins were determined using PDE. Fluorescence contrast between normal liver and tumor tissues was obvious in 32 of 35 patients. A boundary for half the liver or specific liver segments was determined in nine patients by examining the portal vein anatomy after ICG injection. Eight small tumors not observed preoperatively were detected; the smallest was 2 mm.ConclusionsICG fluorescence imaging navigation is a promising, simple, and safe tool for routine real-time intraoperative imaging during hepatic resection and clinical exploration in hepatocellular carcinoma, enabling high sensibility for identifying liver resection margins and detecting tiny superficial tumors.

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