J.Jpn. Surg. Soc.. 127(1): 34-42, 2026

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Feature topic

ICG-VAL-MAP AS A METHOD OF PREOPERATIVE MARKING FOR SMALL LUNG CANCER

With the development and widespread use of radiation equipment such as helical CT, small lung nodules have been detected more frequently in recent years and are being referred to thoracic surgeons on a daily basis. From the perspective that lung cancer is the leading cause of death from malignant diseases, early detection and treatment are important, and the need for surgical diagnostic resection is also increasing. However, such small nodules are difficult to locate during surgery, necessitating some form of preoperative or intraoperative marking. Various marking methods have been developed to address this issue. Historically, percutaneous marking has been widely used, but due to complications and the inability to mark certain lesions, the VAL-MAP (virtual assisted lung MAPping) method, which involves injecting dye via the bronchial route, was developed. Subsequently, the ICG-VAL-MAP method, which overcomes the weaknesses of the VAL-MAP method, was developed and has achieved good results. This paper provides an overview of the history and current status of preoperative and intraoperative marking, explains the practical aspects of the ICG-VAL-MAP method, and discusses future prospects.

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