Infrared fluorescence endoscopy for the diagnosis of superficial gastric tumors.

BACKGROUND Indocyanine green (ICG) is a fluorescent marker that is excited by rays at a wavelength of 768 nm to emit fluorescence at a wavelength of 807 nm in the infrared (IR) range. We developed an IR fluorescence endoscope (IRFE) to observe superficial gastric tumors and assessed its clinical usefulness. OBJECTIVE To evaluate the clinical usefulness of an IRFE for the assessment of superficial gastric tumors. DESIGN An observational study. SETTING University hospital. INTERVENTIONS Newly developed IRFE. PATIENTS Thirty patients with gastric tumors were enrolled in this study, and their lesions were subjected to endoscopic submucosal dissection (ESD), or laparoscopic gastrectomy after observation with the IRFE. METHODS Gastric lesions were subjected to conventional observation, followed by IR fluorescence observation before and after intravenous ICG (0.01 mg/kg) injection. MAIN OUTCOME MEASUREMENTS The relationship between the positive fluorescence and invasivity of each tumor. RESULTS Fluorescence was positive in 8 of 10 gastric cancers with submucosal invasion (80%) and 1 of 20 adenomas or intramucosal gastric cancers (5%); the difference was statistically significant (P<.01). CONCLUSION IRFE is a useful diagnostic tool for estimating the invasivity of gastric tumors.

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