Fluorescent Imaging Using Indocyanine Green for Intraoperative Detection of Endometriosis ID 2683620

INTRODUCTION: Endometriosis is characterized by the presence of endometrial-like tissue outside of the uterus. Definitive diagnosis is made by laparoscopic visualization with confirmatory histopathologic biopsy. In some cases, lesions can be ambiguous or difficult to visualize with traditional white light (WL)-illuminated laparoscopy. The study objective is to evaluate whether the use of indocyanine green (ICG) aids in identification and removal of clear or ambiguous endometriosis lesions, not visualized under traditional WL imaging. METHODS: This is a retrospective chart review of patients with symptoms suspicious for endometriosis where ICG is used during laparoscopy to assist in identification of suspected endometriosis lesions. Data collection includes patient demographics, medical history, surgical history, preoperative symptoms, and localization of lesions. Data will be collected from hospital electronic health record system and from a private practice. RESULTS: In total, 211 suspected lesions were excised, of which 115 had histologically proven endometriosis. 196 lesions were detected using ICG and 112 were confirmed to be endometriosis. These results were statistically significant ( P =.024) with a sensitivity of 97.4% and a negative predictive value of 80%, demonstrating that ICG can significantly improve the intraoperative detection of endometriosis lesions. Research is ongoing with more data being collected. Our goal is that the additional data will further strengthen the power of our study. CONCLUSION: Our study shows that ICG fluorescence significantly improves the intraoperative detection and resection of ambiguous or clear endometriosis lesions and improves histopathologic diagnosis when compared to WL imaging. Indocyanine green has the potential to increase the detection of endometriosis and improve patient outcomes.