Intraoperative identification and characterisation of liver tumours using indocyanine green fluorescence: current status and prospects - 12/09/26

Doi : 10.1016/j.soda.2026.100265

Rodrigue Namèkinsba Doamba ^1,^2,^3,^4,^6,^⁎ , Eric Vibert ^1,^4,^5,⁶, Marc Antoine Allard ^1,^5,⁶, Daniel Azoulay ^1,⁵, René Adam ⁵, Gabriella Pittau ^4,⁵, Chady Salloum ^4,⁵, Oriana Ciacio ^4,⁵, Daniel Pietrasz ^4,^5,⁶, Daniel Cherqui ^1,^5,⁶, Antonio Sa Cunha ^1,^5,⁶, Nicolas Golse ^1,^4,^5,⁶

¹ Paris-Saclay University, Inserm, Physiopathogenesis and Treatment of Liver Diseases, 94805, Villejuif, France

² Tengandogo Teaching Hospital (Burkina Faso)

³ Joseph KI-ZERBO University (Burkina Faso)

⁴ BOPA (Augmented Operating Theatre) Innovation Chair, AP-HP Paul-Brousse Hospital

⁵ AP-HP Paul-Brousse Hospital, Hepato-Biliary Centre, 94800, Villejuif, France

⁶ Inserm, Paris-Saclay University, UMR-S 1193, 94800, Villejuif, France

^⁎ Corresponding author.

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Sous presse. Manuscrit accepté. Disponible en ligne depuis le Saturday 12 September 2026

Key points

•	ICG fluorescence is a useful and recent tool in hepatobiliary surgery.
•	One of the most established indications for ICG is the intraoperative identification of superficial (<1 cm from the capsule) lesions, whether benign or malignant.
•	There is a correlation between the appearance of fluorescence and tumour histology.
•	There are many false positives, requiring histological confirmation (biopsy) or intraoperative ultrasound before the excision of additional unknown lesions.
•	These limitations encourage the development of more specific fluorophores or the development of immunofluorescence techniques.

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Abstract

Intraoperative identification and characterisation of liver tumours using indocyanine green (ICG) fluorescence is increasingly used in liver surgery. This involves administering the vital dye intravenously before surgery, at a dose and timing adapted to the patient's body weight and liver function. During surgery, an infrared camera captures images that identify and display the fluorescence of lesions located near the surface of the liver (and/or the hepatectomy margin) on a screen. This literature review provides an up-to-date overview of the use of this innovative imaging technique, highlighting the potential of ICG fluorescence for detecting and characterising superficial tumours based on fluorescence patterns that correlate with histology. The review also provides an overview of the practical aspects of using ICG fluorescence and an understanding of the molecular mechanisms involved (transporters). Finally, it discusses the current limitations and prospects in liver surgery.

Le texte complet de cet article est disponible en PDF.

Keywords : fluorescence-guided surgery, indocyanine green, tumours, liver resection, pathology