A superstable homogeneous lipiodol-ICG formulation for locoregional hepatocellular carcinoma treatment

Accurate identification of surgical margins for malignancy remains a challenge in the surgical therapy of cancer, and this encountered interoperative difficulties which directly contribute to the prognosis of patients. In recent years, indocyanine green (ICG) has been approved and applied in clinical settings for lesions detection, especially for the precise surgical resection. However, rapid clearance and poor stability greatly limit its clinical practicality. Herein, a super-stable homogeneous iodinated formulation technology (SHIFT) is designed to realize sufficient dispersion of ICG into lipiodol (SHIFTs) for transcatheter embolization (TAE) synergistic fluorescence-guided resection. Particularly, SHIFTs is prepared in a green physical mixture via a carrier-free manner, which possesses controlled morphology, long-term stability, and improved optical characteristics of ICG (fluorescence/photoacoustic/photothermal activities). Furthermore, the viscosity of the synthetic solvent is comparable to lipiodol, and further assessment demonstrated the same efficacy in computed tomography. The performance of SHIFTs in the fluorescence navigation was further evaluated in vivo by TAE therapy to the rabbit VX2 tumor model for a two-week monitor. The integration of near-infrared fluorescence surgery navigation and TAE could effectively guarantee the precise resection for hepatocellular carcinoma. This SHIFT system provides good potentials for ameliorating the dilemma of precise fluorescent navigation for surgical resection after arterial embolization in clinical practice. The superstable homogeneous iodinated formulation technology is developed, and the lipiodol-ICG formulation with long-term stability could act as an embolic agent and tumor bulb for precise tumor resection. [Display omitted] •Superstable homogeneous iodinated formulation technology (SHIFT) is a green physical method without carrier introduction.•A novel lipiodol-ICG formula named SHIFTs shows an enhanced FL/PT/PA capacity.•The SHIFT formulation can embolize the primary liver tumors thoroughly.•A platform integrates embolization and fluorescent-guided surgical resection in HCC.