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Intraoperative ICG NIF Imaging Defines Surgical Margin in MRONJ: A Prospective Observational Study
Dashuang Zhi1, Xinyi Zhang1, Shuyun Wan2
1Research Institute of Stomatology, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Oral and Maxillofacial Head and Neck Oncology Surgery, Nanjing University, Nanjing, China.
Background:
This study explored the feasibility and effectiveness of indocyanine green (ICG)-based near-infrared fluorescence (NIF) imaging for localizing bone lesions associated with medication-related osteonecrosis of the jaw (MRONJ) during surgical intervention.
Methods:
A prospective observational study was conducted on 68 patients who underwent surgical treatment for MRONJ at a single institution between January 2021 and April 2024. Among them, 14 patients received surgery guided by NIF imaging, while the remaining patients underwent surgery without NIF guidance. Postoperative follow-up was performed to assess clinical outcomes.
Results:
There were no significant differences between the two groups regarding age, medication type and duration, underlying disease, lesion location, clinical stage, concomitant symptoms, or surgical approach. NIF imaging remained stable in 14 patients who underwent MRONJ fluorescence surgery. The recurrence rate was lower in the NIF group (14.29%) than in the non-NIF group (27.78%). The difference in the recurrence-free survival curves between the two groups was statistically significant (p = 0.043).
Conclusion:
ICG-mediated NIF imaging provides a reliable method for identifying MRONJ-related bone lesions and offers valuable intraoperative guidance, potentially improving surgical outcomes.
