(P 544) INTRAOPERATIVE EVALUATION OF BONE AND SOFT TISSUE SARCOMA SURGICAL MARGINS WITH INDOCYANINE GREEN FLUORESCENCE IMAGING

Objective: Achieving negative surgical margins is the cornerstone of bone and soft tissue sarcoma management, with positive margins portending a high risk of local recurrence (LR) and overall poor prognosis. Indocyanine green (ICG) is a fluorophore dye which has been utilized intraoperatively to evaluate surgical margins in several malignancies, including breast and gastrointestinal cancers. Given the critical importance of achieving negative margins in sarcomas, ICG fluorescence imaging has the potential to become a valuable intraoperative margin assessment tool for these uncommon and difficult-to-treat cancers. This study sought to evaluate ICG fluorescence imaging’s utility in bone and soft tissue sarcoma resection.

Methods: This prospective non-randomized clinical trial included patients with biopsy-confirmed bone or soft tissue sarcomas undergoing surgical resection. Exclusion criteria included age < 18 years, prior adverse reaction to iodine or fluorescein, and renal disease. Patients received an intravenous ICG infusion dosed at 2.0 mg/kg three hours preoperatively. Intraoperatively, the removed tumor and tumor bed were imaged using a SPY-PHI fluorescent camera (Stryker Co.; Kalamazoo, MI). ICG-positive margins were defined as regions of tumor bed with a fluorescence intensity ≥77% of the resected tumor’s highest measured intensity (Image 1). Sensitivity and specificity were compared between ICG margins, final pathology, and the surgeon’s blinded clinical impression. Cases where ICG matched or did not match final pathology were then grouped and compared using Student’s t-test and Fisher’s exact test (alpha = 0.05).

Results: N/A Trials In Progress

Conclusion: N/A Trials In Progress