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Updated: Oct 26, 2025

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Indocyanine green imaging for pulmonary segmentectomy.

Masaya Yotsukura1, Yu Okubo1, Yukihiro Yoshida1

  • 1Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan.

JTCVS Techniques
|July 28, 2021
PubMed
Summary

Indocyanine green (ICG) effectively delineates the intersegmental plane in pulmonary segmentectomy, regardless of patient lung condition or surgery type. This method offers more precise demarcation than traditional air injection techniques.

Keywords:
FEV1, forced expiratory volume in 1 secondFVC, forced vital capacityGGO, ground-glass opacityHFJV, high-frequency jet ventilation systemICG, indocyanine greenJCOG, Japan Clinical Oncology GroupNSCLC, non–small cell lung cancerindocyanine green in pulmonarynear-infrared imagingpulmonary segmentectomy

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Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Pulmonary segmentectomy requires precise identification of intersegmental planes.
  • Systemic injection of indocyanine green (ICG) is an emerging technique for visualizing these planes.

Purpose of the Study:

  • To evaluate the feasibility of ICG for intersegmental plane delineation in a large cohort.
  • To compare ICG demarcation with air injection, considering segmentectomy type and obstructive lung disorders.

Main Methods:

  • Retrospective analysis of 209 patients undergoing segmentectomy with ICG at a single institution.
  • Assessment of intersegmental plane demarcation and correlation with surgical factors.

Main Results:

  • ICG provided good demarcation in 88.0% of cases, irrespective of segment type or obstructive lung disease.
  • No correlation was found between ICG demarcation quality and resected segments or lung disorders.
  • ICG demarcation was more restricted to the target segment compared to air injection.

Conclusions:

  • ICG is a feasible and effective method for delineating intersegmental planes in pulmonary segmentectomy.
  • Its applicability is not limited by segment type or obstructive lung disorders.
  • ICG offers a more precise alternative to air injection for surgical planning.