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Assessment of Indocyanine Green as a Near-Infrared Fluorescent Contrast Agent for Image-guided Liver Surgery

Phase 1
Completed
Conditions
Liver Neoplasms
Interventions
Procedure: Fluobeam
Registration Number
NCT01738217
Lead Sponsor
Centre Leon Berard
Brief Summary

This is a prospective, monocentric, non-randomized, phase I-II study. The goal is to assess the faisability and the capabilities of fluorescence imaging in hepatic surgery, and specially to help the surgeon while performing liver surgery.

This study will be performed on patient intended to undergo a liver cancer surgery.It will contain three steps, assessing the following items:

* Step 1: to assess the faisability of the use of the Fluobeam, in actual clinical surgical conditions and validate the data obtained in the preclinical phase,

* Step 2: to assess the ability of the combination of ICG and Fluobeam to mark hepatic lesions,

* Step 3: to assess the ability of the combination of ICG and Fluobeam to help in guiding per-hepatectomy.

3 to 6 patients will be enrolled in the first step, 20 in the second step and 20 in the third step.

Patients will be followed during 4 weeks after the surgery.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
48
Inclusion Criteria
  • Adult patient
  • Affected of hepatic cancerous lesions whatever they are
  • Requiring a one or two steps hepatectomy by laparotomy
  • ECOG performance status (PS)≤ 2
  • Mandatory affiliation to health security insurance
  • Written informed consent
Exclusion Criteria
  • With a contraindication or hypersensitivity to ICG administration in medical history
  • Having already undergone a major hepatic surgery (more than three segments) or major biliar surgery (context of major iterative hepatic surgery)
  • Unable to be followed during the duration of the study, for social, family, geographical or psychological reasons
  • Pregnant or breast-feeding woman (urinary strip must be negative at the time of the inclusion in the study for women in age to procreate)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
FluobeamFluobeam-
Primary Outcome Measures
NameTimeMethod
First step: assess the feasibility and the acceptability of FluobeamDuring surgery on day 0

* The ability to detect fluorescence

* The ability to investigate the mobilized parenchyma

* The ability to use the medical device following requested asepsis procedures

* Surgeon satisfaction

* Nurse satisfaction

Second step: assess the rate of patients in whom, all of the lesions (superficial/deep) will be detected by means of the Fluobeam medical device in peroperative or in postoperative.During surgery on day 0
Third step: assess the rate of patients in whom, among the 7 liver segments, the surgeon will be able to selectively target a predefined area.During surgery on day 0
Secondary Outcome Measures
NameTimeMethod
First step: assess the ability to visualize the fluorescent anatomical areasDuring surgery on day 0
First step: Quantify the fluorescenceAfter the surgery, on day 0

by using the images obtained during the surgery

Second step: assess the ability to detect tumor lesions which were not previously known.During surgery on day 0

Assessment of the number of lesions detected thanks to the medical device. The malignant aspect must be confirmed by an anatomopathological analysis.

Third step: assess the ability to detect tumor lesions which were not previously known.During surgery on day 0

Assessment of the number of lesions detected thanks to the medical device. The malignant aspect must be confirmed by an anatomopathological analysis

Third step: assess the ability of the medical device to detect tumor lesions which were previously known.On day 0

Number of lesions seen on images before and during the surgery and detected by Fluobeam.

Second step: assess the rate of modifications of the surgical plan.During surgery on day 0

Number of patients for whom the surgery would be modified after using Fluobeam.

Second step: Quantify the fluorescence.After the surgery, on day 0

From images obtained during the surgery and from the sample analysed by a pathologist.

Second step: assess the number of asepsis due to FluobeamDuring surgery on day 0
Third step: assess the ability to administer two doses of ICG in the same patientOn day 0

one before and one during the surgery (tumor detection and segment targeting respectively).

Second step: assess the quality of the resection margins.After the surgery on day 0

It will be measured using the residual fluorescence and the pathology analysis

First step: assess the ability to review saved dataAfter the surgery, on day 0
Second step: assess the depth limit of detection of the fluorescence.After the pathology analysis on day 0

It will be assessed after the anatomopathological analysis.

Third step: quantify the fluorescence.After the surgery on day 0

From images obtained during the surgery and from the sample analysed by a pathologist.

Third step: assess the number of asepsis due to FluobeamDuring surgery on day 0

Trial Locations

Locations (1)

Centre Léon Bérard

🇫🇷

Lyon Cedex 08, France

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