计算机辅助联合吲哚菁绿分子荧光影像技术在肝脏肿瘤诊断和手术导航中的应用指南（2019版）（英文）  

Guidelines for application of computer-assisted indocyanine green molecular fluorescence imaging in diagnosis and surgical navigation of liver tumors(2019)

作　　者：无 方驰华[7] LU Qiping LAU Wanyee 无;FANG Chihua(Digital Medical Association of Chinese Medical Association;Digital Intelligent Surgery Professional Committee of Chinese Research Hospital Association;Liver Cancer Professional Committee of Chinese Medical Doctor Association;Clinical Precise Medicine Professional Committee of Chinese Medical Doctor Association;Medical Imaging and Equipment Professional Committee of China Graphics Society;Molecular Imaging Professional Committee of China Biophysical Society)

机构地区：[1]中华医学会数字医学分会 [2]中国研究型医院学会数字智能化专业委员会 [3]中国医师协会肝癌专业委员会 [4]中国医师协会临床精准医学专业委员会 [5]中国图学学会医学图像与设备专业委员会 [6]中国生物物理学会分子影像学专业委员会 [7]南方医科大学珠江医院肝胆一科,广东省数字医学临床工程技术研究中心 [8]Department of General Surgery,General Hospital of Central Theater Command [9]Faculty of Medicine,The Chinese University of Hong Kong

出　　处：《南方医科大学学报》2019年第10期1127-1140,共14页Journal of Southern Medical University

基　　金：supported by the grants from the National Key R&D Program(2016YFC0106500);the Major Instrument Project of National Natural Science Foundation of China(81627805);Guangzhou Municipal Science and Technology Development Plan(No.201604020144);NSFC-GD Union Foundation(U1401254);National High-Tech Research and Development Program of China(863 Program,2006AA02Z346 and 2012AA021105);Natural Science Foundation of Guangdong Province(6200171);Production,Teaching and Research Integration Project of Department of Education of Guangdong Province(2009B080701077);Guangdong Provincial Science and Technology Development Program(2012A080203013)~~

摘　　要：计算机辅助联合吲哚菁绿分子荧光影像技术可以从三维的形态解剖和细胞功能水平进行术前规划和术中侦测,从而导航肝癌解剖性、功能性、根治性的肝切除术,临床应用证明其有重要的诊疗价值,此项技术现已在全国得到了广泛推广和应用。为规范计算机辅助联合吲哚菁绿分子荧光影像技术在肝脏肿瘤精准诊疗中的应用,本指南在以下几个方面进行了研究:(1)三维可视化技术应用流程;(2)ICG分子荧光成像的机制及应用流程;(3)三维可视化和虚拟现实技术的临床应用;(4)ICG分子荧光影像技术的临床应用。ICG分子荧光成像技术能从分子、细胞水平层面实现肿瘤边界界定、肝段和肝叶切除切线的确定;微小病灶或转移灶的侦测;术中根据肝脏肿瘤的荧光信号特点,结合术中快速冰冻病理学检查,可初步判定肝脏占位性病变的分化程度;肝切除后对肝断面进行残留肿瘤病灶和胆漏的检测。计算机辅助联合ICG分子荧光影像技术在肝脏肿瘤诊断和手术导航中的应用,为肝脏肿瘤的外科治疗提供了一种新的数字智能化外科诊疗技术,该项技术亦将不断改进和完善,为肝脏肿瘤的精准诊疗展现出良好的应用前景。Computer-assisted combined indocyanine green(ICG)molecular fluorescence imaging technology can be used for preoperative planning and intraoperative detection from three-dimensional(3D)morphological anatomy and level of cellular function to guide the anatomical,functional and radical hepatectomy of liver tumor.This technology has received wide acceptance and has shown important diagnostic and therapeutic value.This guideline is intended to standardize the application of computer-assisted combined ICG molecular fluorescence imaging for accurate diagnosis and treatment of liver tumors in the following aspects:(1)the workflow of 3D visualization technology;(2)the mechanism and application flow of ICG molecular fluorescence imaging;(3)clinical application of 3D visualization technology and virtual reality technology;and(4)clinical application of ICG molecular fluorescence imaging.ICG molecular fluorescence imaging can help to define tumor boundary,determine hepatic segment and hepatic lobectomy tangent at the molecular and cellular level,and detect small lesions or metastases.According to the fluorescence signal characteristics of liver tumors and combined with rapid frozen pathological examination during operation,the differentiation degree of liver space-occupying lesions(such as primary liver cancer)can be preliminarily determined,and residual tumors and biliary leakage on the hepatic section can be detected after hepatectomy.Computer-assisted ICG molecular fluorescence imaging in the diagnosis and surgical navigation of liver tumors provides a new approach to digital diagnosis and treatment of liver tumors.With its development in clinical practice and the technological innovation,this technology will be further improved to allow more accurate diagnosis and treatment of liver tumors.

关 键 词：吲哚菁绿 荧光影像 三维可视化 肝脏肿瘤 导航手术 

分 类 号：R73[医药卫生—肿瘤]