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Photoacoustic tomography of human hepatic malignancies using intraoperative indocyanine green fluorescence imaging.
[cholangiocarcinoma]
Recently
,
fluorescence
imaging
following
the
preoperative
intravenous
injection
of
indocyanine
green
has
been
used
in
clinical
settings
to
identify
hepatic
malignancies
during
surgery
.
The
aim
of
this
study
was
to
evaluate
the
ability
of
photoacoustic
tomography
using
indocyanine
green
as
a
contrast
agent
to
produce
representative
fluorescence
images
of
hepatic
tumors
by
visualizing
the
spatial
distribution
of
indocyanine
green
on
ultrasonographic
images
.
Indocyanine
green
(
0
.
5
mg
/
kg
,
intravenous
)
was
preoperatively
administered
to
9
patients
undergoing
hepatectomy
.
Intraoperatively
,
photoacoustic
tomography
was
performed
on
the
surface
of
the
resected
hepatic
specimens
(
n
 
=
 
10
)
under
excitation
with
an
800
nm
pulse
laser
.
In
4
hepatocellular
carcinoma
nodules
,
photoacoustic
imaging
identified
indocyanine
green
accumulation
in
the
cancerous
tissue
.
In
contrast
,
in
one
hepatocellular
carcinoma
nodule
and
five
adenocarcinoma
foci
(
one
intrahepatic
cholangiocarcinoma
and
4
colorectal
liver
metastases
)
,
photoacoustic
imaging
delineated
indocyanine
green
accumulation
not
in
the
cancerous
tissue
but
rather
in
the
peri-cancerous
hepatic
parenchyma
.
Although
photoacoustic
tomography
enabled
to
visualize
spatial
distribution
of
ICG
on
ultrasonographic
images
,
which
was
consistent
with
fluorescence
images
on
cut
surfaces
of
the
resected
specimens
,
photoacoustic
signals
of
ICG-containing
tissues
decreased
approximately
by
40
%
even
at
4
mm
depth
from
liver
surfaces
.
Photoacoustic
tomography
using
indocyanine
green
also
failed
to
identify
any
hepatocellular
carcinoma
nodules
from
the
body
surface
of
model
mice
with
non-alcoholic
steatohepatitis
.
In
conclusion
,
photoacoustic
tomography
has
a
potential
to
enhance
cancer
detectability
and
differential
diagnosis
by
ultrasonographic
examinations
and
intraoperative
fluorescence
imaging
through
visualization
of
stasis
of
bile-excreting
imaging
agents
in
and
/
or
around
hepatic
tumors
.
However
,
further
technical
advances
are
needed
to
improve
the
visibility
of
photoacoustic
signals
emitted
from
deeply-located
lesions
.
Diseases
Validation
Diseases presenting
"cancer"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
alpha-thalassemia
benign recurrent intrahepatic cholestasis
cadasil
canavan disease
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital adrenal hyperplasia
congenital diaphragmatic hernia
cowden syndrome
cushing syndrome
cutaneous mastocytosis
dedifferentiated liposarcoma
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
gm1 gangliosidosis
heparin-induced thrombocytopenia
hereditary cerebral hemorrhage with amyloidosis
hirschsprung disease
hodgkin lymphoma, classical
inclusion body myositis
junctional epidermolysis bullosa
kabuki syndrome
kallmann syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
monosomy 21
neuralgic amyotrophy
oculocutaneous albinism
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
pendred syndrome
pleomorphic liposarcoma
primary effusion lymphoma
proteus syndrome
pyomyositis
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated