[Effectiveness and safety of CT-guided percutaneous intrapulmonary injection of indocyanine green for localization of pulmonary nodules and ground glass opacity].

Objective: To investigate the effectiveness and safety of CT-guided intrapulmonary injection of indocyanine green (ICG) for preoperative localization of small pulmonary nodules and ground glass opacities. Methods: From October 2018 to July 2019, a total of 34 consecutive patients (39 nodules) who were suspected to be lung cancer and underwent thoracoscopic surgery were enrolled. The size of the nodules was 0.3-2.0 (0.9±0.3) cm, including 6 solid nodules, 9 impure ground glass nodules and 24 pure ground glass nodules. Before operation, ICG was injected into the lung under the guidance of CT for localization. The patient's nodules location, operation and pathology were recorded. The main outcome measures were localization success rate and complication rate. Results: Seven patients (20.6%) had mild complications including six pneumothorax and one intrapulmonary hemorrhage,but all these patients need no special treatment. There was no ICG related side effection all patients. ICG fluorescence can be observed in all localized nodules during surgery. In two patients, the fluorescence was diffused in the thoracic cavity, but the lesion can still be found at the brightest spot of fluorescence. Thirty-eight (97.4%) lesions were successfully found under fluorescence guidance, only one nodule was not found because of its small size (0.3 cm). The shortest fluorescence retention time was more than 5 hours. Conclusion: CT-guided intrapulmonary injection of ICG for localization of pulmonary nodules and ground glass opacities is safe and effective.