Feasibility of real-time near-infrared indocyanine green fluorescence endoscopy for the evaluation of mucosal head and neck lesions

Background. The purpose of this study was to explore the feasibility and potential drawbacks of near-infrared (NIR) endoscopy with indocyanine green (ICG) to examine mucosal head and neck lesions. Methods. NIR ICG endoscopy was applied to image head and neck cancer epithelium in vivo. The evaluation of the ICG videos was performed off-line independently by 2 evaluators and blinded with respect to final histopathological results from biopsies taken as the gold standard. Results. Forty percent of the lesions from 55 patients were histologically malignant. ICG positivity showed a sensitivity, specificity, and accuracy to be related to a malignant tumor of 90.5%, 90.9%, and 89.1%, respectively. The kappa index for the interobserver assessment showed a 94.4% agreement for the assessment of the ICG positivity. Side effects of the NIR ICG endoscopy did not arise. Conclusion. NIR ICG endoscopy in patients with mucosal head and neck lesions was feasible and safe. It might help intraoperatively to differentiate benign from malignant lesions. (C) 2016 The Authors Head & Neck Published by Wiley Periodicals, Inc.