초록접수 현황
| 17F-134 | 구연 발표 |
Fluorescent Iodized Emulsion for Preoperative Localization of Pulmonary Nodule
Hyun Koo Kim¹, Ji Yun Rho¹, Jae Wook Lee2, Yu Hua Quan¹, Byeong Hyeon Choi¹, Rong Xu¹, Kanghoon Lee¹, Kook Nam Han¹, Young Ho Choi¹, Hwan Seok Yong²
¹Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea., ²Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
Purpose : We developed the fluorescent iodized emulsion with indocyanine green (ICG) and lipiodol in order to overcome depth limitation and spreading during limited resection of pulmonary nodule after preoperative localization.
Methods : Different mixing methods were used to find the optimal emulsion of ICG and lipiodol on fluorescent microscope. This emulsion was injected at 15 lung lobes of 3 rabbits under computed-tomography fluoroscopy-guidance and evaluated by fluorescent imaging system and X-ray after thoracotomy. Thirty-two pulmonary nodules of 30 patients were localized with this emulsion preoperatively and the limited pulmonary resections were performed under fluorescent imaging system and C-arm fluoroscopy.
Results : In in vitro, the emulsion mixed with 90% lipiodol and 10% ICG through 90 passages was distributed evenly and the brightest on a fluorescent microscope (Fig. 1). On the rabbit lungs, this optimal emulsion had a better co-localization and remained stably on injection site until 24 hours after injection. The mean diameter of 32 pulmonary nodules was 1.5±0.9cm, and depth from pleura was 1.8±1.0cm. Thirty of 32 pulmonary nodules were successfully resected by wedge resection in 11 and segmentectomy in 19. Resection margin was involved in 2 centrally located nodules, and further resection was performed in one and radiotherapy was planned after surgery due to poor pulmonary function in the other.
Conclusion : We demonstrated that the optimal mixture of iodized fluorescent emulsion would be a good alternative for preoperative localization of the pulmonary nodule through in vitro, in vivo, and clinical trial. The next studies need to develop the new material for better accurate localization.
Methods : Different mixing methods were used to find the optimal emulsion of ICG and lipiodol on fluorescent microscope. This emulsion was injected at 15 lung lobes of 3 rabbits under computed-tomography fluoroscopy-guidance and evaluated by fluorescent imaging system and X-ray after thoracotomy. Thirty-two pulmonary nodules of 30 patients were localized with this emulsion preoperatively and the limited pulmonary resections were performed under fluorescent imaging system and C-arm fluoroscopy.
Results : In in vitro, the emulsion mixed with 90% lipiodol and 10% ICG through 90 passages was distributed evenly and the brightest on a fluorescent microscope (Fig. 1). On the rabbit lungs, this optimal emulsion had a better co-localization and remained stably on injection site until 24 hours after injection. The mean diameter of 32 pulmonary nodules was 1.5±0.9cm, and depth from pleura was 1.8±1.0cm. Thirty of 32 pulmonary nodules were successfully resected by wedge resection in 11 and segmentectomy in 19. Resection margin was involved in 2 centrally located nodules, and further resection was performed in one and radiotherapy was planned after surgery due to poor pulmonary function in the other.
Conclusion : We demonstrated that the optimal mixture of iodized fluorescent emulsion would be a good alternative for preoperative localization of the pulmonary nodule through in vitro, in vivo, and clinical trial. The next studies need to develop the new material for better accurate localization.
책임저자: Hyun Koo Kim
Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
발표자: Hyun Koo Kim, E-mail : kimhyunkoo@korea.ac.kr