Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distribution
Abstract Background Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is an emerging treatment for peritoneal metastasis. Although its aerosol distribution is known to be inhomogeneous, quantitative assessment remains limited. This study introduces a novel approach to quantify the PIPAC drug...
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| Format: | Article |
| Language: | English |
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Springer
2025-08-01
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| Series: | Holistic Integrative Oncology |
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| Online Access: | https://doi.org/10.1007/s44178-025-00184-2 |
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| author | Qiming Fan Renjie Li Xiaosong Lin Zifeng Yang Yong Li |
| author_facet | Qiming Fan Renjie Li Xiaosong Lin Zifeng Yang Yong Li |
| author_sort | Qiming Fan |
| collection | DOAJ |
| description | Abstract Background Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is an emerging treatment for peritoneal metastasis. Although its aerosol distribution is known to be inhomogeneous, quantitative assessment remains limited. This study introduces a novel approach to quantify the PIPAC drug distribution by integrating indocyanine green (ICG) with fluorescent laparoscopy. Methods The optimal ICG concentration (0.1–100 μg/mL) was determined via gray value calibration. Aerosolized ICG (5 μg/mL) was sprayed into an ex vivo box model containing four fresh swine peritoneal samples positioned as follows: (A) bottom directly opposite the nozzle, (B) obstructive bottom, (C) side wall, and (D) top. Fluorescence laparoscopy images were analyzed using ImageJ. Ex vivo validation included doxorubicin (DOX) aerosolization to measure penetration depth. In vivo distribution was assessed in the rabbit abdominal cavities. Results Sample A exhibited the highest ICG deposition (gray value: 219.6 ± 1.0), significantly exceeding samples B (107.4 ± 16.7, p < 0.0001), C (126.9 ± 14.9, p = 0.012), and D (124.4 ± 17.3, p = 0.002). DOX penetration depth was greatest in sample A (342.1 ± 47.3 μm), surpassing B (205.6 ± 38.9 μm, p < 0.0001), C (301.3 ± 36.8 μm, p = 0.002), and D (197.4 ± 47.8 μm, p < 0.0001). In rabbits, maximal ICG accumulation varied anatomically: the bladder (Rabbit 1: 198.1; Rabbit 3: 189.8) and left flank (Rabbit 2: 208.1) showed the highest values, with significant regional heterogeneity. Conclusions This study establishes a fluorescence-based method to quantitatively evaluate PIPAC distribution, demonstrating inhomogeneous drug deposition and penetration both ex vivo and in vivo. These findings highlight the potential of ICG-guided imaging to optimize therapeutic efficacy in clinical PIPAC applications. |
| format | Article |
| id | doaj-art-f3119d9086e44e1caa2d0fb75e29fd37 |
| institution | Kabale University |
| issn | 2731-4529 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Springer |
| record_format | Article |
| series | Holistic Integrative Oncology |
| spelling | doaj-art-f3119d9086e44e1caa2d0fb75e29fd372025-08-24T11:57:06ZengSpringerHolistic Integrative Oncology2731-45292025-08-014111010.1007/s44178-025-00184-2Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distributionQiming Fan0Renjie Li1Xiaosong Lin2Zifeng Yang3Yong Li4Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityDepartment of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical UniversityAbstract Background Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is an emerging treatment for peritoneal metastasis. Although its aerosol distribution is known to be inhomogeneous, quantitative assessment remains limited. This study introduces a novel approach to quantify the PIPAC drug distribution by integrating indocyanine green (ICG) with fluorescent laparoscopy. Methods The optimal ICG concentration (0.1–100 μg/mL) was determined via gray value calibration. Aerosolized ICG (5 μg/mL) was sprayed into an ex vivo box model containing four fresh swine peritoneal samples positioned as follows: (A) bottom directly opposite the nozzle, (B) obstructive bottom, (C) side wall, and (D) top. Fluorescence laparoscopy images were analyzed using ImageJ. Ex vivo validation included doxorubicin (DOX) aerosolization to measure penetration depth. In vivo distribution was assessed in the rabbit abdominal cavities. Results Sample A exhibited the highest ICG deposition (gray value: 219.6 ± 1.0), significantly exceeding samples B (107.4 ± 16.7, p < 0.0001), C (126.9 ± 14.9, p = 0.012), and D (124.4 ± 17.3, p = 0.002). DOX penetration depth was greatest in sample A (342.1 ± 47.3 μm), surpassing B (205.6 ± 38.9 μm, p < 0.0001), C (301.3 ± 36.8 μm, p = 0.002), and D (197.4 ± 47.8 μm, p < 0.0001). In rabbits, maximal ICG accumulation varied anatomically: the bladder (Rabbit 1: 198.1; Rabbit 3: 189.8) and left flank (Rabbit 2: 208.1) showed the highest values, with significant regional heterogeneity. Conclusions This study establishes a fluorescence-based method to quantitatively evaluate PIPAC distribution, demonstrating inhomogeneous drug deposition and penetration both ex vivo and in vivo. These findings highlight the potential of ICG-guided imaging to optimize therapeutic efficacy in clinical PIPAC applications.https://doi.org/10.1007/s44178-025-00184-2Pressurized intraperitoneal aerosol chemotherapyDrug distributionIndocyanine greenFluorescence |
| spellingShingle | Qiming Fan Renjie Li Xiaosong Lin Zifeng Yang Yong Li Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distribution Holistic Integrative Oncology Pressurized intraperitoneal aerosol chemotherapy Drug distribution Indocyanine green Fluorescence |
| title | Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distribution |
| title_full | Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distribution |
| title_fullStr | Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distribution |
| title_full_unstemmed | Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distribution |
| title_short | Indocyanine green-activated fluorescence laparoscopy imaging: a novel quantitative assessment method for intraperitoneal aerosolized drug distribution |
| title_sort | indocyanine green activated fluorescence laparoscopy imaging a novel quantitative assessment method for intraperitoneal aerosolized drug distribution |
| topic | Pressurized intraperitoneal aerosol chemotherapy Drug distribution Indocyanine green Fluorescence |
| url | https://doi.org/10.1007/s44178-025-00184-2 |
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