Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations
Indocyanine green (ICG) is one of the only clinically approved near-infrared (NIR) fluorophores used during fluorescence-guided surgery (FGS), but it lacks tumor specificity for pancreatic ductal adenocarcinoma (PDAC). Several tumor-targeted fluorescent probes have been evaluated in PDAC patients, y...
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| Language: | English |
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MDPI AG
2023-01-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/3/652 |
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| author | Lysanne D. A. N. de Muynck Kevin P. White Adnan Alseidi Elisa Bannone Luigi Boni Michael Bouvet Massimo Falconi Hans F. Fuchs Michael Ghadimi Ines Gockel Thilo Hackert Takeaki Ishizawa Chang Moo Kang Norihiro Kokudo Felix Nickel Stefano Partelli Elena Rangelova Rutger Jan Swijnenburg Fernando Dip Raul J. Rosenthal Alexander L. Vahrmeijer J. Sven D. Mieog |
| author_facet | Lysanne D. A. N. de Muynck Kevin P. White Adnan Alseidi Elisa Bannone Luigi Boni Michael Bouvet Massimo Falconi Hans F. Fuchs Michael Ghadimi Ines Gockel Thilo Hackert Takeaki Ishizawa Chang Moo Kang Norihiro Kokudo Felix Nickel Stefano Partelli Elena Rangelova Rutger Jan Swijnenburg Fernando Dip Raul J. Rosenthal Alexander L. Vahrmeijer J. Sven D. Mieog |
| author_sort | Lysanne D. A. N. de Muynck |
| collection | DOAJ |
| description | Indocyanine green (ICG) is one of the only clinically approved near-infrared (NIR) fluorophores used during fluorescence-guided surgery (FGS), but it lacks tumor specificity for pancreatic ductal adenocarcinoma (PDAC). Several tumor-targeted fluorescent probes have been evaluated in PDAC patients, yet no uniformity or consensus exists among the surgical community on the current and future needs of FGS during PDAC surgery. In this first-published consensus report on FGS for PDAC, expert opinions were gathered on current use and future recommendations from surgeons’ perspectives. A Delphi survey was conducted among international FGS experts via Google Forms. Experts were asked to anonymously vote on 76 statements, with ≥70% agreement considered consensus and ≥80% participation/statement considered vote robustness. Consensus was reached for 61/76 statements. All statements were considered robust. All experts agreed that FGS is safe with few drawbacks during PDAC surgery, but that it should not yet be implemented routinely for tumor identification due to a lack of PDAC-specific NIR tracers and insufficient evidence proving FGS’s benefit over standard methods. However, aside from tumor imaging, surgeons suggest they would benefit from visualizing vasculature and surrounding anatomy with ICG during PDAC surgery. Future research could also benefit from identifying neuroendocrine tumors. More research focusing on standardization and combining tumor identification and vital-structure imaging would greatly improve FGS’s use during PDAC surgery. |
| first_indexed | 2024-03-11T09:51:17Z |
| format | Article |
| id | doaj.art-a52345e9a4e54d6dbed19092a00e4280 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T09:51:17Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-a52345e9a4e54d6dbed19092a00e42802023-11-16T16:15:14ZengMDPI AGCancers2072-66942023-01-0115365210.3390/cancers15030652Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future RecommendationsLysanne D. A. N. de Muynck0Kevin P. White1Adnan Alseidi2Elisa Bannone3Luigi Boni4Michael Bouvet5Massimo Falconi6Hans F. Fuchs7Michael Ghadimi8Ines Gockel9Thilo Hackert10Takeaki Ishizawa11Chang Moo Kang12Norihiro Kokudo13Felix Nickel14Stefano Partelli15Elena Rangelova16Rutger Jan Swijnenburg17Fernando Dip18Raul J. Rosenthal19Alexander L. Vahrmeijer20J. Sven D. Mieog21Department of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsScienceRight Research Consulting, London, ON N6A 3S9, CanadaDepartment of Surgery, University of California, San Francisco, CA 94143, USADepartment of General and Pancreatic Surgery, The Pancreas Institute, 37134 Verona, ItalyDepartment of Surgery, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, 20122 Milano, ItalyDepartment of Surgery, University of California, San Diego, CA 92093, USAPancreas Translational & Clinical Research Center, Vita-Salute San Raffaele University, 20132 Milan, ItalyDepartment of Surgery, University of Cologne, 50923 Köln, GermanyDepartment of General, Visceral and Pediatric Surgery, University of Göttingen, 37075 Goettingen, GermanyDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, 04103 Leipzig, GermanyDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, 69120 Heidelberg, GermanyHepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, JapanDepartment of Hepatobiliary and Pancreatic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of KoreaNational Center for Global Health and Medicine, Tokyo 162-8655, JapanDepartment of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, 69120 Heidelberg, GermanyPancreas Translational & Clinical Research Center, Vita-Salute San Raffaele University, 20132 Milan, ItalyDepartment of Upper Abdominal Surgery, Sahlgrenska University Hospital, 413 45 Gothenburg, SwedenDepartment of Surgery, Amsterdam University Medical Center—Location AMC, 1105 AZ Amsterdam, The NetherlandsCleveland Clinic Florida, Weston, FL 33331, USACleveland Clinic Florida, Weston, FL 33331, USADepartment of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsDepartment of Surgery, Leiden University Medical Center, 2333 ZA Leiden, The NetherlandsIndocyanine green (ICG) is one of the only clinically approved near-infrared (NIR) fluorophores used during fluorescence-guided surgery (FGS), but it lacks tumor specificity for pancreatic ductal adenocarcinoma (PDAC). Several tumor-targeted fluorescent probes have been evaluated in PDAC patients, yet no uniformity or consensus exists among the surgical community on the current and future needs of FGS during PDAC surgery. In this first-published consensus report on FGS for PDAC, expert opinions were gathered on current use and future recommendations from surgeons’ perspectives. A Delphi survey was conducted among international FGS experts via Google Forms. Experts were asked to anonymously vote on 76 statements, with ≥70% agreement considered consensus and ≥80% participation/statement considered vote robustness. Consensus was reached for 61/76 statements. All statements were considered robust. All experts agreed that FGS is safe with few drawbacks during PDAC surgery, but that it should not yet be implemented routinely for tumor identification due to a lack of PDAC-specific NIR tracers and insufficient evidence proving FGS’s benefit over standard methods. However, aside from tumor imaging, surgeons suggest they would benefit from visualizing vasculature and surrounding anatomy with ICG during PDAC surgery. Future research could also benefit from identifying neuroendocrine tumors. More research focusing on standardization and combining tumor identification and vital-structure imaging would greatly improve FGS’s use during PDAC surgery.https://www.mdpi.com/2072-6694/15/3/652fluorescence-guided surgeryintraoperative imagingpancreatic cancercancer surgerynear-infrared fluorescenceindocyanine green |
| spellingShingle | Lysanne D. A. N. de Muynck Kevin P. White Adnan Alseidi Elisa Bannone Luigi Boni Michael Bouvet Massimo Falconi Hans F. Fuchs Michael Ghadimi Ines Gockel Thilo Hackert Takeaki Ishizawa Chang Moo Kang Norihiro Kokudo Felix Nickel Stefano Partelli Elena Rangelova Rutger Jan Swijnenburg Fernando Dip Raul J. Rosenthal Alexander L. Vahrmeijer J. Sven D. Mieog Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations Cancers fluorescence-guided surgery intraoperative imaging pancreatic cancer cancer surgery near-infrared fluorescence indocyanine green |
| title | Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations |
| title_full | Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations |
| title_fullStr | Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations |
| title_full_unstemmed | Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations |
| title_short | Consensus Statement on the Use of Near-Infrared Fluorescence Imaging during Pancreatic Cancer Surgery Based on a Delphi Study: Surgeons’ Perspectives on Current Use and Future Recommendations |
| title_sort | consensus statement on the use of near infrared fluorescence imaging during pancreatic cancer surgery based on a delphi study surgeons perspectives on current use and future recommendations |
| topic | fluorescence-guided surgery intraoperative imaging pancreatic cancer cancer surgery near-infrared fluorescence indocyanine green |
| url | https://www.mdpi.com/2072-6694/15/3/652 |
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