ABSTRACT Introduction Despite advances in lung cancer management, it remains the leading cause of cancer‐related deaths. Low‐dose computed tomography (LDCT) screening has increased detection of small, difficult‐to‐palpate lung lesions. Materials and Methods This retrospective study at Chang Gung Memorial Hospital (2014–2022) evaluated the feasibility of image‐guided segmentectomy (I‐segmentectomy) using indocyanine green (ICG) for lesion localization and intersegmental plane navigation. Results A total of 260 patients with 266 pulmonary lesions were enrolled in the study cohort, with 122 lesions undergoing image‐guided segmentectomy (I‐segmentectomy). After propensity score matching, lesions resected using the I‐segmentectomy method provided appropriate resection margins and margin‐to‐tumor ratios, particularly for lesions larger than 1 cm. Additionally, operation times were shorter with I‐segmentectomy. Survival analysis showed no significant differences in disease‐free and overall survival; although I‐segmentectomy maintained a 100% survival rate. Conclusion Overall, I‐segmentectomy with dual ICG fluorescence imaging is a feasible, safe, and effective method for ensuring adequate resection margins in difficult‐to‐discern lung lesions. Further prospective studies are necessary to validate these findings and assess long‐term outcomes.
Wu et al. (Fri,) studied this question.