Indocyanine Green in Hepatocellular Carcinoma Research

High-Priority Research Topics

The European Association for the Study of the Liver (EASL) guidelines reference laparoscopic anatomical liver resection using ICG fluorescence imaging for improved outcomes in cirrhotic patients 5
Prospective multicenter trials with standardized imaging protocols, quantitative fluorescence measurements, and comprehensive genomic profiling are needed to validate associations between ICG fluorescence patterns and molecular subtypes of HCC, as recommended by the Theranostics journal 1, 2
Large prospective studies comparing ICG fluorescence to enhanced MRI, PET-CT, and intraoperative ultrasound for detection of occult disease are required, with long-term oncologic outcomes as primary endpoints, according to Gastroenterology and Journal of Clinical Oncology 3, 4

Standardized protocols for data acquisition and reporting are necessary for future ICG fluorescence studies to enable cross-study comparisons and regulatory approval, as stated in Theranostics 1, 2
Phase II/III randomized controlled trials are urgently needed to demonstrate superiority over standard-of-care before widespread adoption, with primary endpoints focusing on morbidity, mortality, and quality of life outcomes, as recommended by Gastroenterology, Journal of Clinical Oncology, and Journal of Hepatology 2, 3, 4, 6, 7, 9