A method to identify pulmonary intersegmental planes with intravenous vitamin B₂ injection

Area of Science:

• Pulmonary surgery
• Surgical imaging techniques
• Biomedical fluorescence

Background:

• Identifying pulmonary intersegmental planes is crucial for accurate lung segmentectomy.
• Current methods like inflation-deflation and indocyanine green (ICG) have limitations.

Purpose of the Study:

• To investigate the efficacy of intravenous vitamin B2 with fluorescence imaging for identifying pulmonary intersegmental planes.
• To evaluate vitamin B2 as a potential replacement for inflation-deflation and ICG methods.

Main Methods:

• Experiment 1: Intravenous vitamin B2 injection in pigs to visualize intersegmental planes for segmentectomy, comparing fluorescence lines with inflation-deflation lines.
• Experiment 2: Comparative analysis of vitamin B2 and ICG fluorescence area and duration after intravenous injection in the same pigs.

Main Results:

• Vitamin B2 clearly visualized pulmonary intersegmental planes with yellow-green fluorescence for over 60 minutes in all pigs.
• The vitamin B2 fluorescence line accurately matched the inflation-deflation line.
• Vitamin B2 fluorescence area and duration were comparable to ICG fluorescence.

Conclusions:

• Intravenous vitamin B2 with fluorescence imaging is a simple, safe, and accurate method for visualizing pulmonary intersegmental planes in a pig model.
• This technique presents a promising alternative to the inflation-deflation technique and intravenous ICG for lung surgery.