BRIEF CLINICAL REPORTSIntraoperative Near-infrared Fluorescence (NIR) Imaging With Indocyanine Green (ICG) Can Identify Bone and Soft Tissue Sarcomas Which May Provide Guidance for Oncological ResectionNicoli, Fabio MD, PhD∗,†,‡; Saleh, Daniel B. FRCS∗; Baljer, Bence MBBS∗,†; Chan, Corey D. MBBS†; Beckingsale, Tom FRCS§; Ghosh, Kanishka M. FRCS§; Ragbir, Maniram FRCS∗; Rankin, Kenneth S. FRCS†,§Author Information ∗Department of Plastic and Reconstructive Surgery, Royal Victoria Infirmary Hospital Newcastle NHS Foundation Trust, Newcastle upon Tyne, UK †Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK ‡Department of Plastic and Reconstructive Surgery, Northumbria Healthcare NHS Foundation Trust, Northumberland, UK §North of England Bone and Soft Tissue Tumour Service, Freeman Hospital Newcastle NHS Foundation Trust, Newcastle upon Tyne, UK. [email protected]. None of the authors has financial conflicts or interests to report in association with the contents of this paper. The datasets generated during the current study are available from the corresponding author on reasonable request and are stored at the NHS Trust. F.N., D.B.S., and K.S.R. drafted the manuscript, designed the study, aided in interpreting the results, and wrote original draft. T.B. and M.K.G. were involved in writing, review, and editing the manuscript, then supervised the manuscript and participants. M.R. was involved in conceptualization, planning, conducted experiments, and supervised the work. C.D.C. and B.B. performed the measurements, collected data and pictures, processed the experimental data, performed the analysis. All authors discussed the results and commented on the manuscript. The authors report no conflicts of interest. Annals of Surgery: February 2021 - Volume 273 - Issue 2 - p e63-e68 doi: 10.1097/SLA.0000000000003857 Buy Metrics Abstract Background: Complete excision of sarcomas to maximize function without compromising the oncological outcome can be challenging. The aim of this study was to investigate the feasibility and potential drawbacks of near-infrared (NIR) fluorescence imaging with indocyanine green during resection of bone and soft tissue sarcomas. Methods: Eleven patients with high-grade sarcomas were enrolled in the study. All patients received intravenous indocyanine green (75 mg) between 16 and 24 hours before the resection. Sarcomas were resected under NIR guidance and specimens were sent for routine histopathological analysis. Results: Majority of treatment naive tumors demonstrated fluorescence. There were no adverse events from the indocyanine green administration. In 3 cases, the fluorescence was reported by the surgeon to have been of definite guidance leading to further tissue resection to improve the margin. Conclusion: This is the first report of NIR fluorescence guidance in the setting of open sarcoma surgery. The technique is acceptable to patients and surgeons and was able to guide resection. Multicenter studies are required to assess the utility of this technique in a large cohort of patients with regards to quantification of fluorescence, resection guidance, and longer follow-up period. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.