{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:23:48Z","timestamp":1794324228964,"version":"4.9.0"},"reference-count":29,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,5]]},"abstract":"\n Object<\/jats:title>\n As demonstrated by histological and neuroimaging studies, pituitary adenomas have a capillary vascular density that differs significantly from that of surrounding structures. The authors hypothesized that intraoperative indocyanine green (ICG) fluorescence endoscopy could be used to visually differentiate tumor from surrounding tissues, including normal pituitary gland and dura.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n After institutional review board approval, 16 patients undergoing endoscopic transsphenoidal surgery for benign pituitary lesions were prospectively enrolled in the study. A standard endoscopic endonasal approach to the sella was completed. Each patient then underwent endoscopic examination of the sellar dura and then the exposed pituitary adenoma after ICG bolus injection (12.5\u201325 mg). This examination was performed using a custom endoscope with a near-infrared light source and excitation wavelength filter.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The authors successfully recorded ICG fluorescence from sellar dura, pituitary, and surrounding structures in 12 of 16 patients enrolled. There were 3 technical failures of intraoperative ICG endoscopy, and 1 patient was excluded following discovery of a dye cross-allergy. A standard dose of 25 mg of ICG in 10 ml of aqueous solution optimized visualization of sellar region microvasculature within 45 seconds of peripheral bolus injection. Adenoma was less fluorescent than normal pituitary gland. Dural invasion by tumor was identifiable by a marked increase in fluorescence compared with native dura. The ICG endoscopic examination added 15\u201320 minutes of operative time under general anesthesia. There were no complications that resulted from use of ICG or the fluorescent light source.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Indocyanine green fluorescence endoscopy shows promise as an intraoperative modality to visually distinguish pituitary tumors from normal tissue and to visually identify areas of dural invasion, thereby facilitating complete tumor resection and minimizing injury to surrounding structures. These results support the continued development of fluorescence endoscopic resection techniques.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2012.1.jns11601","type":"journal-article","created":{"date-parts":[[2012,2,24]],"date-time":"2012-02-24T10:00:00Z","timestamp":1330077600000},"page":"935-941","source":"Crossref","is-referenced-by-count":80,"title":["Indocyanine green fluorescence endoscopy for visual differentiation of pituitary tumor from surrounding structures"],"prefix":"10.3171","volume":"116","author":[{"given":"Zachary N.","family":"Litvack","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, George Washington University, Washington DC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns11601","series-title":"Cathet Cardiovasc Diagn","first-page":"231","article-title":"Adverse reactions to indocyanine green: a case report and a review of the literature","volume":"17","author":"Benya","year":"1989"},{"key":"b2-jns11601","series-title":"Eur Radiol","first-page":"543","article-title":"Magnetic resonance imaging of pituitary adenomas","volume":"15","author":"Bonneville","year":"2005"},{"key":"b3-jns11601","series-title":"Basic Clin Pharmacol Toxicol","first-page":"357","article-title":"The prevalence of suspected and challenge-verified penicillin allergy in a university hospital population","volume":"98","author":"Borch","year":"2006"},{"key":"b4-jns11601","series-title":"Surv 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