Evidence map›Paper›PMID 32266547›Full record

SynthesisSurgical endoscopy2020

Intraoperative fluorescence imaging with indocyanine green in hepatic resection for malignancy: a systematic review and meta-analysis of diagnostic test accuracy studies.

Kieran Purich, Jerry T Dang, Ali Poonja, Warren Y L Sun, David Bigam, Daniel Birch, Shahzeer Karmali

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kieran PurichDivision of General Surgery, Faculty of Medicine and Dentistry, 2D Walter C. Mackenzie Health Sciences Centre, University of Alberta Department of Surgery, Edmonton, AB, Canada. kpurich@ualberta.ca.
Jerry T DangDivision of General Surgery, Faculty of Medicine and Dentistry, 2D Walter C. Mackenzie Health Sciences Centre, University of Alberta Department of Surgery, Edmonton, AB, Canada.
Ali PoonjaFaculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Warren Y L SunDivision of General Surgery, Faculty of Medicine and Dentistry, 2D Walter C. Mackenzie Health Sciences Centre, University of Alberta Department of Surgery, Edmonton, AB, Canada.
David BigamDivision of General Surgery, Faculty of Medicine and Dentistry, 2D Walter C. Mackenzie Health Sciences Centre, University of Alberta Department of Surgery, Edmonton, AB, Canada.
Daniel BirchDivision of General Surgery, Faculty of Medicine and Dentistry, 2D Walter C. Mackenzie Health Sciences Centre, University of Alberta Department of Surgery, Edmonton, AB, Canada.
Shahzeer KarmaliDivision of General Surgery, Faculty of Medicine and Dentistry, 2D Walter C. Mackenzie Health Sciences Centre, University of Alberta Department of Surgery, Edmonton, AB, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFluorescence imaging during hepatic resection has the potential to identify additional malignant tumors, increasing the chance for complete tumor resection. Indocyanine green (ICG) is an FDA approved, fluorescent dye used in a variety of surgical procedures. The objective of this study was to define the sensitivity of intraoperative ICG fluorescent imaging in the detection of hepatic malignancy in adult patients during hepatic resection, which was accomplished by performing a systematic review and meta-analysis.

methodsThe databases Medline, EMBASE, Scopus and Web of Science were assessed in September 2018. Article inclusion criteria was (1) Liver resection for malignancy (2) ICG injected pre or intraoperatively (3) Use of infrared electronic endoscopy or near-infrared fluorescence imaging intraoperatively (4) Patient age ≥ 18 years (5) N > 5 patients (6) Human and English studies only. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines were used for quality assessment. Data synthesis was completed using Meta-Disc and MedCalc software. A DerSimonian-Laird random effects model was used for the meta-analysis.

results21 studies and 841 patients were included in our systematic review. Seven studies and 319 patients were included in the meta-analysis. The pooled sensitivity of intraoperative ICG fluorescence was 0.75 (0.71-0.79). Sensitivity for superficial tumors ranged from 0.96 to 1.00. Heterogeneity (I

conclusionThe sensitivity of intraoperative ICG-related imaging for superficial tumors is high; however, overall sensitivity is low, at 0.75, suggesting that it would have to be used in combination with current identification methods such as intraoperative ultrasound. Our study also found that intraoperative ICG fluorescence imaging was able to detect additional malignant hepatic tumors in 11.6% of patients.

Indexed as

Fluorescent DyesIndocyanine GreenAdultFluorescenceHepatectomyHumansIntraoperative CareLiver NeoplasmsMiddle AgedSpectroscopy, Near-InfraredUltrasonographyFluorescent DyesIndocyanine GreenHepatectomyHepaticICGIndocyanine greenMalignancy

Identifiers

PMID32266547

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.