Využití fluorescencí navigované chirurgie v oblasti hlavy a krku

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Autoři: M. Kaňa ; J. Plzák ; M. Zábrodský ; J. Bouček
Působiště autorů: Homolka, Prague ; Department of Otorhinolaryngology and Head and Neck Surgery, 1st Medical Faculty, Charles University and University Hospital Motol and
Vyšlo v časopise: Otorinolaryngol Foniatr, 75, 2026, No. 3, pp. 259-270.
Kategorie: Přehledový článek
doi: https://doi.org/10.48095/ccorl2026-011

Souhrn

Fluorescenčně navigovaná chirurgie (FGS) je intraoperační zobrazovací technika, která zlepšuje vizualizaci anatomických struktur a patologických tkání v reálném čase. V anatomicky náročných regionech, jako je oblast hlavy a krku, zlepšuje FGS chirurgickou přesnost a výsledky operace. Toto review poskytuje ucelený přehled klinických aplikací, technických aspektů a současných pokroků v oblasti fluorescenčně navigované chirurgie v oboru otolaryngologie a chirurgie hlavy a krku. FGS prokázala významný přínos při identifikaci kritických anatomických struktur, jako jsou cévy, nervy a struktury lymfatického systému, a při hodnocení perfuze volných i stopkatých laloků. Její využití se obzvláště osvědčilo v chirurgii štítné žlázy a příštítných tělísek, kde přispívá ke snížení míry komplikací. Rychle rozvíjející se jsou také aplikace FGS v onkochirurgii, zejména při intraoperačním hodnocení rozsahu nádoru, ex vivo hodnocení chirurgických okrajů a detekce sentinelových lymfatických uzlin. Přestože počet fluoroforů schválených pro klinické využití zůstává omezený, rostoucí množství probíhajících klinických studií poukazuje na značný potenciál této technologie. FGS představuje účinnou metodu, která zlepšuje vizualizaci a rozlišení struktur v průběhu operace, zvyšuje její bezpečnost a zlepšuje onkologické a funkční výsledky

Klíčová slova:

příštítná tělíska – karcinom hlavy a krku – chirurgické okraje – Lymfatická uzlina – fluorescenčně navigovaná chirurgie – near-infrared

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Zdroje

1. Rosenthal EL, Warram JM, de Boer E et al. Safety and Tumor Specificity of Cetuximab-IRDye800 for Surgical Navigation in Head and Neck Cancer. Clin Cancer Res 2015; 21 (16): 3658–3666. Doi: 10.1158/1078-0432.CCR-14-3284.

2. Crawford KL, Pacheco FV, Lee YJ et al. A Scoping Review of Ongoing Fluorescence-Guided Surgery Clinical Trials in Otolaryngology. Laryngoscope 2022; 132 (1): 36–44. Doi: 10.1002/lary.29891.

3. Drezek R, Sokolov K, Utzinger U et al. Understanding the contributions of NADH and collagen to cervical tissue fluorescence spectra: modeling, measurements, and implications. J Biomed Opt 2001; 6 (4): 385–396. Doi: 10.1117/1.1413209.

4. Wu M, Gong D, Zhou Y et al. Activatable probes with potential for intraoperative tumor-specific fluorescence-imaging guided surgery. J Mater Chem B 2023; 11 (41): 9777–9797. Doi: 10.1039/d3tb01590d.

5. Liu J, Xu Z, Meng C et al. Acidic tumor microenvironment-activatable fluorescent diagnostic probe for the rapid identification and resection of human tumors via spraying. Biosens Bioelectron 2023; 234 : 115343. Doi: 10.1016/j.bios.2023.115343

6. Zeinerová L, Černý M, Homoláč M et al. Využití fluoresceinu ke zlepšení senzitivity flexibilního endoskopického vyšetření polykání Otorinolaryngol Foniatr 2023; 72 (2): 127–135. Doi: 10.48095/ccorl2023127.

7. Archibald SJ, Holland JP, Korde A et al.. Combining Nuclear Medicine With Other Modalities: Future Prospect for Multimodality Imaging. Mol Imaging 2024; 23 : 15353508241245265. Doi: 10.1177/15353508241245265.

8. Schaafsma BE, Mieog JS, Hutteman M et al. The clinical use of indocyanine green as a near-infrared fluorescent contrast agent for image--guided oncologic surgery. J Surg Oncol 2011; 104 (3): 323–332. Doi: 10.1002/jso.21943.

9. van Leeuwen FWB, Schottelius M, Brouwer OR et al. Trending: Radioactive and Fluorescent Bimodal/Hybrid Tracers as Multiplexing Solutions for Surgical Guidance. J Nucl Med 2020; 61 (1): 13–19. Doi: 10.2967/jnumed.119.228684.

10. van Leeuwen FW, Valdes-Olmos R, Buckle T et al. Hybrid surgical guidance based on the integration of radionuclear and optical technologies. Br J Radiol 2016; 89 (1062): 20150797. Doi: 10.1259/bjr.20150797.

11. Devgan Y, Mayilvaganan S, Mishra A et al. Comparison of indocyanine green angiography vs intraoperative parathyroid hormone in early prediction of risk of post-thyroidectomy hypocalcemia: a prospective cohort study. Ann Med Surg (Lond) 2024; 86 (2): 678–688. Doi: 10.1097/MS9.0000000000001578.

12. Srinivasan A, Kaminskaite V, Winter SC. The Use of Fluorescent Markers to Detect and Delineate Head and Neck Cancer: A Scoping Review. Clin Otolaryngol 2025; 50 (2): 220–240. Doi: 10.1111/coa.14263.

13. Suero Molina E, Bruneau M, Reuter G et al. Fluorescence guidance in skull base surgery: Applications and limitations –⁠ A systematic review. Brain Spine 2024; 4 : 103328. Doi: 10.1016/j.bas.2024.103328.

14. Lee YJ, van den Berg NS, Orosco RK et al. A narrative review of fluorescence imaging in robotic-assisted surgery. Laparosc Surg 2021; 5. Doi: 10.21037/ls-20-98

15. Scott-Wittenborn N, Jackson RS. Intraoperative imaging during minimally invasive transoral robotic surgery using near-infrared light. Am J Otolaryngol 2018; 39 (2): 220–222. Doi: 10.1016/j.amjoto.2017.09.001.

16. Bergenfelz A, Barczynski M, Heie A et al. Impact of autofluorescence for detection of parathyroid glands during thyroidectomy on postoperative parathyroid hormone levels: parallel multicentre randomized clinical trial. Br J Surg 2023; 110 (12): 1824–1833. Doi: 10.1093/bjs/znad278.

17. Frey S, Bannani S, Caillard C et al. Parathyroid near-infrared autofluorescence use for parathyroidectomy in mild primary hyperparathyroidism: Results from a randomized monocentric trial. Surgery 2025; 177 : 108878. Doi: 10.1016/j.surg.2024.05.062.

18. Gao RW, Teraphongphom NT, van den Berg NS et al. Determination of Tumor Margins with Surgical Specimen Mapping Using Near-Infrared Fluorescence. Cancer Res 2018; 78 (17): 5144–5154. Doi: 10.1158/0008-5472.CAN-18-0878.

19. Lauwerends LJ, Abbasi H, Bakker Schut TC et al. The complementary value of intraoperative fluorescence imaging and Raman spectroscopy for cancer surgery: combining the incompatibles. Eur J Nucl Med Mol Imaging 2022; 49 (7): 2364–2376. Doi: 10.1007/s00259-022-05705-z.

20. Schopper S, Smeets R, Gosau M et al. Intraoperative ICG-based fluorescence-angiography in head and neck reconstruction: Predictive value for impaired perfusion of free flaps. J Craniomaxillofac Surg 2022; 50 (4): 371–379. Doi: 10.1016/j.jcms.2021.09.020.

21. Yeoh MS, Kim DD, Ghali GE. Fluorescence angiography in the assessment of flap perfusion and vitality. Oral Maxillofac Surg Clin North Am 2013; 25 (1): 61–66. Doi: 10.1016/j.coms.2012.11.004.

22. Galli A, Salerno E, Bramati C et al. Indocyanine green fluorescence video-angiography for flap perfusion assessment in head and neck reconstruction: a prospective study. Eur Arch Otorhinolaryngol 2025; 282 (2): 961–970. Doi: 10.1007/s00405-024-08959-5.

23. Beckler AD, Ezzat WH, Seth R et al. Assessment of Fibula Flap Skin Perfusion in Patients Undergoing Oromandibular Reconstruction: Comparison of Clinical Findings, Fluorescein, and Indocyanine Green Angiography. JAMA Facial Plast Surg 2015; 17 (6): 422–426. Doi: 10.1001/jamafacial.2015.0961.

24. Abdelwahab M, Kandathil CK, Most SP et al. Utility of Indocyanine Green Angiography to Identify Clinical Factors Associated With Perfusion of Paramedian Forehead Flaps During Nasal Reconstruction Surgery. JAMA Facial Plast Surg 2019; 21 (3): 206–212. Doi: 10.1001/jamafacial.2018.1829.

25. Giordano L, Galli A, Familiari M et al. Head and neck pedicled flap autonomization using a new high-resolution indocyanine green fluorescence video-angiography device. Head Neck 2022; 44 (6): 1496–1499. Doi: 10.1002/hed.27051.

26. Schlosshauer T, Rothenberger J, Heiss C et al. The role of near-infrared fluorescence imaging with indocyanine green dye in pedicle division with the paramedian forehead flap. Int Wound J 2021; 18 (6): 881–888. Doi: 10.1111/iwj.13590.

27. Surowitz JB, Most SP. Use of laser-assisted indocyanine green angiography for early division of the forehead flap pedicle. JAMA Facial Plast Surg 2015; 17 (3): 209–214. Doi: 10.1001/jamafacial.2015.0171.

28. Giordano L, Familiari M, Galli A et al. Trimming of Facial Artery Myomucosal Flap (FAMM) using Indocyanine Green Fluorescence Video-Angiography: Operative Nuances. Ann Surg Oncol 2022; 29 (13): 8361. Doi: 10.1245/s10434-022-12171-2.

29. Shaikh N, O‘Brien D, Makary C et al. Intraoperative Indocyanine Green Angiography for Assessing Flap Perfusion in Skull Base Reconstruction: A Systematic Review. J Neurol Surg B Skull Base 2022; 83 (Suppl 2): e492–e500. Doi: 10.1055/s-0041-1732309.

30. Daum R, Grimm DR, Yong M et al. Using Indocyanine Green Fluorescence Angiography to Evaluate the Impact of Surgical and Patient Factors on Posterior Septal Artery Perfusion in Endoscopic Skull Base Surgery. J Neurol Surg B Skull Base 2024. Doi: 10.1055/s-0044-1792078.

31. Noiphithak R, Yanez-Siller JC, Rukskul P et al. Indocyanine Green Angiography for Real-time Evaluation of Nasoseptal Flap Vascularity and Perfusion. Laryngoscope 2025; 135 (3): 1060–1065. Doi: 10.1002/lary.31975.

32. Singaravelu A, McCarrick C, Potter S et al. Clinical and Cost-Effectiveness of Intraoperative Flap Perfusion Assessment With Indocyanine Green Fluorescence Angiography in Breast and Head and Neck Reconstructions: A Systematic Review and Meta-Analysis. Microsurgery 2024; 44 (8): e31250. Doi: 10.1002/micr.31250.

33. Ohba S, Yokoyama J, Fujimaki M et al. Significant improvement in superselective intra-arterial chemotherapy for oral cancer by using indocyanine green fluorescence. Oral Oncol 2012; 48 (11): 1101–1105. Doi: 10.1016/j.oraloncology.2012.08.007.

34. Sethi HK, Sina EM, Mady LJ et al. Sentinel lymph node biopsy for head and neck malignancies utilizing simultaneous radioisotope gamma probe and indocyanine green fluorescence navigation. Head Neck 2024; 46 (1): 212–217. Doi: 10.1002/hed.27563.

35. Bredell MG. Sentinel lymph node mapping by indocyanin green fluorescence imaging in oropharyngeal cancer –⁠ preliminary experience. Head Neck Oncol 2010; 2 : 31. Doi: 10.1186/1758-3284-2-31.

36. Stoffels I, Leyh J, Poppel T et al. Evaluation of a radioactive and fluorescent hybrid tracer for sentinel lymph node biopsy in head and neck malignancies: prospective randomized clinical trial to compare ICG -⁠ (99m) Tc-nanocolloid hybrid tracer versus (99m) Tc-nanocolloid. Eur J Nucl Med Mol Imaging 2015; 42 (11): 1631–1638. Doi: 10.1007/s00259-015-3093-7.

37. Chao AH, Schulz SA, Povoski SP. The application of indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging for assessment of the lymphatic system in reconstructive lymphaticovenular anastomosis surgery. Expert Rev Med Devices 2021; 18 (4): 367–374. Doi: 10.1080/17434440.2021.1900725.

38. Mito D, Wang YM, Wu SC et al. Use of Microscope-Integrated Near-Infrared Fluorescence for Enhancing Deep Lymphatic Vessel Detection during Supermicrosurgical Lymphaticovenous Anastomosis: A Longitudinal Cohort Study. Plast Reconstr Surg 2022; 149 (5): 1227–1233. Doi: 10.1097/PRS.0000000000009050.

39. Maus EA, Tan IC, Rasmussen JC et al. Near-infrared fluorescence imaging of lymphatics in head and neck lymphedema. Head Neck 2012; 34 (3): 448–453. Doi: 10.1002/hed.21538.

40. van Heumen S, Riksen JJM, Bramer WM et al. Imaging of the Lymphatic Vessels for Surgical Planning: A Systematic Review. Ann Surg Oncol 2023; 30 (1): 462–479. Doi: 10.1245/s10434-022-12552-7.

41. Gorobeiko M, Dinets A. Unexpected mapping of recurrent laryngeal nerve by fluorescence-guided surgery using near-infrared indocyanine green angiography. International Journal of Endocrinology (Ukraine) 2023; 19 (5): 349–353.

42. Kwon JG, Choi YJ, Kim SC et al. A technique for safe deep facial tissue dissection: Indocyanine green-assisted intraoperative real-time visualization of the vasa nervorum of facial nerve with a near-infrared camera. J Craniomaxillofac Surg 2019; 47 (11): 1819–1826. Doi: 10.1016/j.jcms.2019.07.011.

43. Haubner F, Gassner HG, Brawanski A et al. Fluorescein sodium-guided surgery of parotid gland tumors as a technical advance. BMC Ear Nose Throat Disord 2017; 17 : 6. Doi: 10.1186/s12901-017-0039-7.

44. Wang LG, Barth CW, Combs JR et al. Investigation of Oxazine and Rhodamine Derivatives as Peripheral Nerve Tissue Targeting Contrast Agent for In Vivo Fluorescence Imaging. Proc SPIE Int Soc Opt Eng 2019; 10862. Doi: 10.1117/12.2507296.

45. Wang LG, Montano AR, Masillati AM et al. Nerve Visualization using Phenoxazine-Based Near-Infrared Fluorophores to Guide Prostatectomy. Adv Mater 2024; 36 (16): e2304724. Doi: 10.1002/adma.202304724.

46. Barth CW, Shah VM, Wang LG et al. Clinically translatable formulation strategies for systemic administration of nerve-specific probes. Adv Ther (Weinh) 2021; 4 (7). Doi: 10.1002/adtp.202100002.

47. Hussain T, Mastrodimos MB, Raju SC et al. Fluorescently labeled peptide increases identification of degenerated facial nerve branches during surgery and improves functional outcome. PLoS One 2015; 10 (3): e0119600. Doi: 10.1371/journal.pone.0119600.

48. Whitney MA, Crisp JL, Nguyen LT et al. Fluorescent peptides highlight peripheral nerves during surgery in mice. Nat Biotechnol 2011; 29 (4): 352–356. Doi: 10.1038/nbt.1764.

49. Berehova N, van Meerbeek MP, Azargoshasb S et al. A Truncated 14-Amino-Acid Myelin Protein-Zero-Targeting Peptide for Fluorescence-Guided Nerve-Preserving Surgery. Biomolecules 2023; 13 (6). Doi: 10.3390/biom13060942.

50. Buckle T, Hensbergen AW, van Willigen DM et al. Intraoperative visualization of nerves using a myelin protein-zero specific fluorescent tracer. EJNMMI Res 2021; 11 (1): 50. Doi: 10.1186/s13550-021-00792-9.

51. Szafran DA, Shams NA, Montano A et al. Two--color fluorescence-guided surgery for head and neck cancer resections. J Biomed Opt 2025; 30 (Suppl 1): S13707. Doi: 10.1117/1.JBO.30.S1.S13707.

52. De Ravin E, Venkatesh S, Harmsen S et al. Indocyanine green fluorescence-guided surgery in head and neck cancer: A systematic review. Am J Otolaryngol 2022; 43 (5): 103570. Doi: 10.1016/j.amjoto.2022.103570.

53. Voskuil FJ, de Jongh SJ, Hooghiemstra WTR et al. Fluorescence-guided imaging for resection margin evaluation in head and neck cancer patients using cetuximab-800CW: A quantitative dose-escalation study. Theranostics 2020; 10 (9): 3994-4005. Doi: 10.7150/thno.43227.

54. Moore LS, Rosenthal EL, de Boer E et al. Effects of an Unlabeled Loading Dose on Tumor-Specific Uptake of a Fluorescently Labeled Antibody for Optical Surgical Navigation. Mol Imaging Biol 2017; 19 (4): 610–616. Doi: 10.1007/s11307-016-1022-1.

55. Moore LS, Rosenthal EL, Chung TK et al. Characterizing the Utility and Limitations of Repurposing an Open-Field Optical Imaging Device for Fluorescence-Guided Surgery in Head and Neck Cancer Patients. J Nucl Med 2017; 58 (2): 246–251. Doi: 10.2967/jnumed.115.171413.

56. ClinicalTrials.gov. Trials: NCT03733210, NCT04511078, NCT03282461, NCT04191460, NCT03085147.

57. Gao RW, Teraphongphom N, de Boer E et al. Safety of panitumumab-IRDye800CW and cetuximab-IRDye800CW for fluorescence-guided surgical navigation in head and neck cancers. Theranostics 2018; 8 (9): 2488–2495. Doi: 10.7150/thno.24487.

58. van Keulen S, van den Berg NS, Nishio N et al. Rapid, non-invasive fluorescence margin assessment: Optical specimen mapping in oral squamous cell carcinoma. Oral Oncol 2019; 88 : 58–65. Doi: 10.1016/j.oraloncology.2018.11.012.

59. Krishnan G, van den Berg NS, Nishio N et al. Fluorescent Molecular Imaging Can Improve Intraoperative Sentinel Margin Detection in Oral Squamous Cell Carcinoma. J Nucl Med 2022; 63 (8): 1162–1168. Doi: 10.2967/jnumed.121.262235.

60. Steinkamp PJ, Voskuil FJ, van der Vegt B et al. A Standardized Framework for Fluorescence-Guided Margin Assessment for Head and Neck Cancer Using a Tumor Acidosis Sensitive Optical Imaging Agent. Mol Imaging Biol 2021; 23 (6): 809–817. Doi: 10.1007/s11307-021-01614-z.

61. Voskuil FJ, Steinkamp PJ, Zhao T et al. Exploiting metabolic acidosis in solid cancers using a tumor-agnostic pH-activatable nanoprobe for fluorescence-guided surgery. Nat Commun 2020; 11 (1): 3257. Doi: 10.1038/s41467-020-16814-4.

62. Marsden M, Weyers BW, Bec J et al. Intraoperative Margin Assessment in Oral and Oropharyngeal Cancer Using Label-Free Fluorescence Lifetime Imaging and Machine Learning. IEEE Trans Biomed Eng 2021; 68 (3): 857–868. Doi: 10.1109/TBME.2020.3010480.

63. Weyers BW, Marsden M, Sun T et al. Fluorescence lifetime imaging for intraoperative cancer delineation in transoral robotic surgery. Transl Biophotonics 2019; 1 (1–2). Doi: 10.1002/tbio.201900017.

64. Aaboubout Y, Ten Hove I, Smits RWH et al. Specimen-driven intraoperative assessment of resection margins should be standard of care for oral cancer patients. Oral Dis 2021; 27 (1): 111–116. Doi: 10.1111/odi.13619.

65. Thomas Robbins K, Triantafyllou A, Suarez C et al. Surgical margins in head and neck cancer: Intra -⁠ and postoperative considerations. Auris Nasus Larynx 2019; 46 (1): 10–17. Doi: 10.1016/j.anl.2018.08.011.

66. Teraphongphom N, Kong CS, Warram JM et al. Specimen mapping in head and neck cancer using fluorescence imaging. Laryngoscope Investig Otolaryngol 2017; 2 (6): 447–452. Doi: 10.1002/lio2.84.

67. Higginson JA, Breik O, Thompson AH et al. Diagnostic accuracy of intraoperative margin assessment techniques in surgery for head and neck squamous cell carcinoma: A meta-analysis. Oral Oncol 2023; 142 : 106419. Doi: 10.1016/j.oraloncology.2023.106419.

68. Atallah I, Milet C, Coll JL et al. Role of near-infrared fluorescence imaging in head and neck cancer surgery: from animal models to humans. Eur Arch Otorhinolaryngol 2015; 272 (10): 2593–2600. Doi: 10.1007/s00405-014-3224-y.

69. White HW, Naveed AB, Campbell BR et al. Infrared Fluorescence-guided Surgery for Tumor and Metastatic Lymph Node Detection in Head and Neck Cancer. Radiol Imaging Cancer 2024; 6 (4): e230178. Doi: 10.1148/rycan.230178.

70. Alvarez Amezaga J, Barbier Herrero L, Pijoan del Barrio JI et al. Diagnostic efficacy of sentinel node biopsy in oral squamous cell carcinoma. Cohort study and meta-analysis. Med Oral Patol Oral Cir Bucal 2007; 12 (3): E235–E243.

71. Koual M, Benoit L, Nguyen-Xuan HT et al. Diagnostic value of indocyanine green fluorescence guided sentinel lymph node biopsy in vulvar cancer: A systematic review. Gynecol Oncol 2021; 161 (2): 436–441. Doi: 10.1016/j.ygyno.2021.01.031.

72. Thompson CF, St John MA, Lawson G et al. Diagnostic value of sentinel lymph node biopsy in head and neck cancer: a meta-analysis. Eur Arch Otorhinolaryngol 2013; 270 (7): 2115–2122. Doi: 10.1007/s00405-012-2320-0.

73. Venkatesh S, De Ravin E, Rajasekaran K. Indocyanine green fluorescence-guided sentinel lymph node biopsy: a systematic review. World J Otorhinolaryngol Head Neck Surg 2024; 15 (4): 298–307. Doi: 10.1002/wjo2.197.

74. Nakamura T, Kogashiwa Y, Nagafuji H et al. Validity of sentinel lymph node biopsy by ICG fluorescence for early head and neck cancer. Anticancer Res 2015; 35 (3): 1669–1674.

75. Krishnan G, van den Berg NS, Nishio N et al. Metastatic and sentinel lymph node mapping using intravenously delivered Panitumumab-IRDye800CW. Theranostics 2021; 11 (15): 7188–7198. Doi: 10.7150/thno.55389.

76. Li M, Zheng X, Han T et al. Near-infrared-II ratiometric fluorescence probes for non-invasive detection and precise navigation surgery of metastatic sentinel lymph nodes. Theranostics 2022; 12 (16): 7191–7202. Doi: 10.7150/thno.78085.

77. Pace-Asciak P, Russell J, Solorzano C et al. The utility of parathyroid autofluorescence as an adjunct in thyroid and parathyroid surgery 2023. Head Neck 2023; 45 (12): 3157–3167. Doi: 10.1002/hed.27538.

78. Wang B, Zhu CR, Liu H et al. The Accuracy of Near Infrared Autofluorescence in Identifying Parathyroid Gland During Thyroid and Parathyroid Surgery: A Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12 : 701253. Doi: 10.3389/fendo.2021.701253.

79. Kim DH, Kim SH, Jung J et al. Indocyanine green fluorescence for parathyroid gland identification and function prediction: Systematic review and meta-analysis. Head Neck 2022; 44 (3): 783–791. Doi: 10.1002/hed.26950.

80. Abood A, Rolighed L, Ovesen T et al. Autofluorescence-guided hemithyroidectomy in a low--volume thyroid institution with no experience in parathyroid surgery: randomized clinical trial. Br J Surg 2024; 111 (4). Doi: 10.1093/bjs/znae075.

81. Di Lorenzo S, Carrillo Lizarazo JL, Dionigi G et al. Impact of near-infrared fluorescence imaging plus indocyanine green fluorescence on postoperative hypoparathyroidism rates after total thyroidectomy and central neck lymph node dissection. Br J Surg 2024; 111 (2). Doi: 10.1093/bjs/znae022.

82. Maser C, Kohlbrenner AH, Dirks R. Use of Indocyanine Green and Fluorescence Angiography in Parathyroid Surgery: A Feasibility Study. Surg Innov 2020; 27 (6): 587–593. Doi: 10.1177/1553350620956437.

83. Barbieri D, Indelicato P, Vinciguerra A et al. Autofluorescence and Indocyanine Green in Thyroid Surgery: A Systematic Review and Meta-Analysis. Laryngoscope 2021; 131 (7): 1683–1692. Doi: 10.1002/lary.29297.

84. Ouyang H, Wang B, Sun B et al. Application of Indocyanine Green Angiography in Bilateral Axillo-Breast Approach Robotic Thyroidectomy for Papillary Thyroid Cancer. Front Endocrinol (Lausanne) 2022; 13 : 916557. Doi: 10.3389/fendo.2022.916557.

85. van Keulen S, Nishio N, Fakurnejad S et al. The Clinical Application of Fluorescence-Guided Surgery in Head and Neck Cancer. J Nucl Med 2019; 60 (6): 758–763. Doi: 10.2967/jnumed.118.222810.

86. Nishio N, van den Berg NS, van Keulen S et al. Optical molecular imaging can differentiate metastatic from benign lymph nodes in head and neck cancer. Nat Commun 2019; 10 (1): 5044. Doi: 10.1038/s41467-019-13076-7.

87. Rosenthal EL, Moore LS, Tipirneni K et al. Sensitivity and Specificity of Cetuximab-IRDye800CW to Identify Regional Metastatic Disease in Head and Neck Cancer. Clin Cancer Res 2017; 23 (16): 4744–4752. Doi: 10.1158/1078-0432.CCR-16-2968.

88. Thammineedi SR, Saksena AR, Nusrath Set al. Fluorescence-guided cancer surgery-A new paradigm. J Surg Oncol 2021; 123 (8): 1679–1698. Doi: 10.1002/jso.26469.

89. Zhao J, Jin G, Weng G et al. Recent advances in activatable fluorescence imaging probes for tumor imaging. Drug Discov Today 2017; 22 (9): 1367–1374. Doi: 10.1016/j.drudis.2017.04.006.

90. Zhu L, Ma Y, Kiesewetter DO et al. Rational design of matrix metalloproteinase-13 activatable probes for enhanced specificity. ACS Chem Biol 2014; 9 (2): 510–516. Doi: 10.1021/cb400698s.

91. Kataoka H, Nishie H, Hayashi N et al. New photodynamic therapy with next-generation photosensitizers. Ann Transl Med 2017; 5 (8): 183. Doi: 10.21037/atm.2017.03.59.

92. Meulemans J, Delaere P, Vander Poorten V. Photodynamic therapy in head and neck cancer: indications, outcomes, and future prospects. Curr Opin Otolaryngol Head Neck Surg 2019; 27 (2): 136–141. Doi: 10.1097/MOO. 0000000000000521.

93. Ullah Z, Roy S, Muhammad S et al. Fluorescence imaging-guided surgery: current status and future directions. Biomater Sci 2024; 12 (15): 3765–3804. Doi: 10.1039/d4bm00410h.