Journal Article

A clinical trial of super-stable homogeneous lipiodol-nanoICG formulation-guided precise fluorescent laparoscopic hepatocellular carcinoma resection

Liu, Hao, Liu, Gang, Li, Jingdong, Tian, Jie, Zheng, Yating, Cheng, Hongwei, Zhang, Yang, Chu, Chengchao, Chen, Biaoqi, Mao, Jingsong, Chen, Aizheng, Ye, Jinfa, He, Pan, Xiong, Yongfu

2022

Overview

Background Applying traditional fluorescence navigation technologies in hepatocellular carcinoma is severely restricted by high false-positive rates, variable tumor differentiation, and unstable fluorescence performance. Results In this study, a green, economical and safe nanomedicine formulation technology was developed to construct carrier-free indocyanine green nanoparticles (nanoICG) with a small uniform size and better fluorescent properties without any molecular structure changes compared to the ICG molecule. Subsequently, nanoICG dispersed into lipiodol via a super-stable homogeneous intermixed formulation technology (SHIFT&nanoICG) for transhepatic arterial embolization combined with fluorescent laparoscopic hepatectomy to eliminate the existing shortcomings. A 52-year-old liver cancer patient was recruited for the clinical trial of SHIFT&nanoICG. We demonstrate that SHIFT&nanoICG could accurately identify and mark the lesion with excellent stability, embolism, optical imaging performance, and higher tumor-to-normal tissue ratio, especially in the detection of the microsatellite lesions (0.4 × 0.3 cm), which could not be detected by preoperative imaging, to realize a complete resection of hepatocellular carcinoma under fluorescence laparoscopy in a shorter period (within 2 h) and with less intraoperative blood loss (50 mL). Conclusions This simple and effective strategy integrates the diagnosis and treatment of hepatocellular carcinoma, and thus, it has great potential in various clinical applications.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Advancing Nanomedicine Towards Clinical Translation / Alcohol / Analysis / Biotechnology / Cancer therapies / Carbon dioxide / Carcinoma, Hepatocellular - diagnostic imaging / Carcinoma, Hepatocellular - surgery / Care and treatment / Cell culture / Chemistry / Chemistry and Materials Science / Chromatography / Coloring Agents / CT imaging / Cytotoxicity / Diagnosis / Embolism / Embolization / Ethanol / Ethiodized Oil / Fluorescence / Fluorescent laparoscope / Hepatectomy / Hepatocellular carcinoma / Hepatoma / Humans / Indocyanine Green / Indocyanine green nanoparticles / Laparoscopy / Laparoscopy - methods / Lesions / Liver cancer / Liver Neoplasms - diagnostic imaging / Liver Neoplasms - surgery / Magnetic resonance imaging / Medical imaging / Methods / Middle Aged / Molecular Medicine / Molecular structure / Nanomedicine / Nanoparticles / Nanotechnology / Optical Imaging - methods / Patient outcomes / Pharmaceuticals / Risk factors / Surgery / Technology / Theranostics / Tomography / Translational medicine / Tumors / Veins & arteries