This is a study to assess the ability of Indocyanine Green (ICG) to identify neoplastic
disease. For many pediatric solid tumors, complete resection of the primary site and/or
metastatic deposits is critical for achieving a cure. An optimal intra-operative tool to help
visualize tumor and its margins would be of benefit. ICG real-time fluorescence imaging is a
technique being used increasingly in adults for this purpose. We propose to use it during
surgery for pediatric malignancies. All patients with tumors that require localization for
resection or biopsy of the tumor and/or metastatic lesions will be eligible.
Primary Objective
To assess the feasibility of Indocyanine Green (ICG)-mediated near-infrared (NIR) imagery to
identify neoplastic disease during the conduct of surgery to resect neoplastic lesions in
children and adolescents. NIR imaging will be done at the start of surgery to assess
NIR-positivity of the lesion(s) and at the end of surgery to assess completeness of
resection. Separate assessments will be made for the following different histologic
categories:
1. Osteosarcoma
2. Ewing Sarcoma
3. Rhabdomyosarcoma (RMS)
4. Non-Rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS)
5. Neuroblastoma
6. Renal tumors
7. Metastatic pulmonary deposits
8. Liver tumors, lymphoma, other rare tumors, and nodules of unknown etiology
Exploratory Objectives
1. To compare the ICG uptake by primary vs metastatic site and pre-treated (chemotherapy,
radiation, or both) vs non-pre-treated.
2. Assess the sensitivity and specificity of NIR imagery to find additional lesions not
identified by standard of care intraoperative inspection and tactile feedback.
3. Assess the sensitivity and specificity of NIR imagery to find additional lesions not
identified on preoperative diagnostic imaging.
4. Assess the sensitivity and specificity of NIR imagery for identifying residual disease
at the conclusion of a tumor resection.