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Indocyanine green is a sensitive adjunct in the identification and surgical management of local and metastatic hepatoblastoma

Video Published 2026-01-23

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Topic Overview

Retrospective study of 29 pediatric hepatoblastoma patients demonstrates that indocyanine green fluorescence imaging achieved 91% sensitivity in identifying metastatic lesions and assisted in tumor localization in 50% of cases. ICG proved particularly valuable for detecting occult lesions not visible on preoperative imaging and delineating resection margins, though specificity was limited by false positives.

Key Takeaways

  • - ICG fluorescence imaging achieved 91% sensitivity in identifying metastatic hepatoblastoma lesions across 120 thoracic specimens. - In 10% of operations, hepatoblastoma-positive specimens were resected based solely on ICG-avidity without preoperative imaging detection. - ICG assisted in tumor localization in 50% of cases, proving valuable for detecting occult lesions not visible on preoperative imaging. - False positives limit ICG specificity to 57%, but no adverse outcomes resulted from additional resections guided by ICG findings. - Thoracoscopic surgery is safe for lower disease burden cases, with straightforward conversion to thoracotomy when needed.

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