5 Key Points:
- Prior studies demonstrated a failure to identify and localize head and
neck cancers via near-infrared (NIR) imaging of indocyanine green
(ICG) with a robot-integrated platform. However, our group
demonstrated success in visualization of neoplasms using a
commercially available dedicated NIR camera system and a technique
called second window ICG (SWIG), in which ICG is injected 24 hours
pre-operatively.
- We aimed to evaluate the SWIG technique in patients undergoing
transoral robotic surgery (TORS) for oropharyngeal squamous cell
carcinoma (OPSCC) and compare two NIR camera systems.
- System 1 showed poor tumor-margin delineation with no fluorescence in
4/6 cases (66.7%) and only minimal fluorescence in the remaining 2
cases (33.3%).
- System 2 showed marked fluorescence in 5/6 cases (83.3%), with good
margin definition in 4 cases (66.7%). In 2 cases (33.3%), System 2
also identified tumor that was not visible under white light.
- In this preliminary case series, we found that System 2 outperforms
System 1 in NIR imaging with SWIG during TORS for oropharyngeal tumor
resection.