74 timestamped statements
across 2 topics
— auto-found in recorded discussions, each timestamp jumps to the exact moment.
Summaries Gloria gave as host are listed separately below.
Featured statements
▶Ep 593 · 3:30
The tumor cells are really, they're replicating. So they have really high or rapidly dividing cancer cells to consume folate all the time. They're avid for folate. So if you mix folate with fluorescence, we're going to see it green during the surgery.
The marking procedure is done under CT guidance. There interventional radiologist mark the nodule with Lipiodol, a dye that remains in place for up to 3 months.
clinicalSurgery can improve survival in patients with lung metastases↗
▶Ep 4 · 1:20
clinicalComplete resection of all nodules is necessary for optimal outcomes↗
▶Ep 4 · 1:30
clinicalMinimally invasive surgery is feasible for patients with one or two nodules↗
▶Ep 4 · 1:40
epidemiologicalThe conversion rate due to failure to localize subdural nodules during thoracoscopy is 47%↗
▶Ep 4 · 1:50
quoteThe answer is 47%. That means the conversion rate is really high.↗
▶Ep 4 · 2:00
clinicalConversion rate is much higher without double lung ventilation↗
▶Ep 4 · 2:20
clinicalCT guidance during thoracoscopy exposes the patient to radiation continuously↗
▶Ep 4 · 2:30
clinicalUltrasound is difficult for localizing very small nodules↗
▶Ep 4 · 2:40
clinicalCalcified lesions in osteosarcoma are difficult to visualize with ultrasound↗
▶Ep 4 · 2:50
quoteThe rate reported for dislodgement is 2.4 to 22%.↗
▶Ep 4 · 2:50
epidemiologicalHook wire dislodgement rate is reported as 2.4 to 22%↗
▶Ep 4 · 3:00
clinicalHook wire dislodgement rate is higher when patients must travel from CT scan to OR under anesthesia↗
▶Ep 4 · 3:10
clinicalMethylene blue often spreads throughout the chest rather than remaining localized to nodules↗
▶Ep 4 · 3:10
quoteWe have seen methylene blue all over the chest, but not in the nodules too many times.↗
▶Ep 4 · 3:20
quoteif you have a deeper nodule, like 2 centimeters deep in nodule, you cannot use ICG.↗
▶Ep 4 · 3:20
clinicalICG cannot be used for nodules deeper than 2 centimeters↗
▶Ep 4 · 3:30
quoteThe marking procedure is done under CT guidance. There interventional radiologist mark the nodule with Lipiodol, a dye that remains in place for up to 3 months.↗
▶Ep 4 · 3:30
clinicalLipiodol marking is performed under CT guidance by interventional radiologists↗
▶Ep 4 · 3:40
clinicalLipiodol remains in place for up to 3 months after injection↗
▶Ep 4 · 3:50
clinicalSurgery can be performed up to one week after Lipiodol marking↗
▶Ep 4 · 3:50
quoteI don't do the surgery the same day, if I can't, for example, I can do it one week later.↗
▶Ep 4 · 4:00
clinicalIntraoperative C-arm fluoroscopy is used to localize Lipiodol-marked nodules↗
▶Ep 4 · 4:10
clinicalComplete resection is verified by radioscopy and palpation of the resected specimen↗
▶Ep 4 · 4:20
epidemiologicalDr. Gonzalez used Lipiodol in 33 patients with three or four nodules per patient↗
▶Ep 4 · 4:30
epidemiologicalThe technique was used across multiple histologies including osteosarcoma, Ewing sarcoma, Wilms tumor, and infectious disease↗
▶Ep 4 · 4:40
quoteWe have done like I said, 50 nodules with 100% sensitivity. That's awesome.↗
▶Ep 4 · 4:40
epidemiologicalLipiodol marking achieved 100% sensitivity in localizing 50 nodules↗
Gloria's statements about Pediatric Oncology43 statements
clinicalComplete resection of all nodules is necessary for optimal outcomes↗
▶Ep 537 · 1:30
clinicalMinimally invasive surgery is feasible for patients with one or two nodules↗
▶Ep 537 · 1:40
epidemiologicalThe conversion rate due to failure to localize subdural nodules during thoracoscopy is 47%↗
▶Ep 537 · 1:50
quoteThe answer is 47%. That means the conversion rate is really high.↗
▶Ep 537 · 2:00
clinicalConversion rate is much higher without double lung ventilation↗
▶Ep 537 · 2:20
clinicalCT guidance during thoracoscopy exposes the patient to radiation continuously↗
▶Ep 537 · 2:30
clinicalUltrasound is difficult for localizing very small nodules↗
▶Ep 537 · 2:40
clinicalCalcified lesions in osteosarcoma are difficult to visualize with ultrasound↗
▶Ep 537 · 2:50
quoteThe rate reported for dislodgement is 2.4 to 22%.↗
▶Ep 537 · 2:50
epidemiologicalHook wire dislodgement rate is reported as 2.4 to 22%↗
▶Ep 537 · 3:00
clinicalHook wire dislodgement rate is higher when patients must travel from CT scan to OR under anesthesia↗
▶Ep 537 · 3:10
clinicalMethylene blue often spreads throughout the chest rather than remaining localized to nodules↗
▶Ep 537 · 3:10
quoteWe have seen methylene blue all over the chest, but not in the nodules too many times.↗
▶Ep 537 · 3:20
quoteif you have a deeper nodule, like 2 centimeters deep in nodule, you cannot use ICG.↗
▶Ep 537 · 3:20
clinicalICG cannot be used for nodules deeper than 2 centimeters↗
▶Ep 537 · 3:30
clinicalLipiodol marking is performed under CT guidance by interventional radiologists↗
▶Ep 537 · 3:30
quoteThe marking procedure is done under CT guidance. There interventional radiologist mark the nodule with Lipiodol, a dye that remains in place for up to 3 months.↗
▶Ep 537 · 3:40
clinicalLipiodol remains in place for up to 3 months after injection↗
▶Ep 537 · 3:50
clinicalSurgery can be performed up to one week after Lipiodol marking↗
▶Ep 537 · 3:50
quoteI don't do the surgery the same day, if I can't, for example, I can do it one week later.↗
▶Ep 537 · 4:00
clinicalIntraoperative C-arm fluoroscopy is used to localize Lipiodol-marked nodules↗
▶Ep 537 · 4:10
clinicalComplete resection is verified by radioscopy and palpation of the resected specimen↗
▶Ep 537 · 4:20
epidemiologicalDr. Gonzalez used Lipiodol in 33 patients with three or four nodules per patient↗
▶Ep 537 · 4:30
epidemiologicalThe technique was used across multiple histologies including osteosarcoma, Ewing sarcoma, Wilms tumor, and infectious disease↗
▶Ep 537 · 4:40
epidemiologicalLipiodol marking achieved 100% sensitivity in localizing 50 nodules↗
▶Ep 537 · 4:40
quoteWe have done like I said, 50 nodules with 100% sensitivity. That's awesome.↗
2025 Pediatric Surgery Update Course - Updates in Oncology
▶Ep 593 · 2:10
quoteICG is a fluorescence element that we can see during the surgery. So if we're looking at like an laparoscopic normal laparoscopic, we're not going to see anything. Just pinky stuff, yellow stuff, that's it. Normal colors. But if we put the nearest, we're going to see something's in green.↗
▶Ep 593 · 2:30
clinicalICG (indocyanine green) is excreted through the liver, so liver tumor cells that don't excrete ICG well will retain the dye and appear fluorescent during surgery.↗
▶Ep 593 · 3:17
clinicalPafolacianine (Cytalux) is an FDA-approved targeted fluorescence molecule used in adult cancer patients that binds folate to a fluorescent marker, exploiting the high folate receptor expression in rapidly dividing cancer cells.↗
▶Ep 593 · 3:30
quoteThe tumor cells are really, they're replicating. So they have really high or rapidly dividing cancer cells to consume folate all the time. They're avid for folate. So if you mix folate with fluorescence, we're going to see it green during the surgery.↗
▶Ep 593 · 5:40
clinicalDinutuximab is a monoclonal antibody used in neuroblastoma that can be conjugated with fluorescent markers for intraoperative tumor visualization.↗
▶Ep 593 · 7:00
clinicalTwo ongoing pediatric studies are evaluating pafolacianine safety: one at Lurie Children's Hospital for metastatic patients and one at Mayo Clinic for all solid tumors.↗
▶Ep 593 · 7:10
clinicalPafolacianine is currently used off-label at Cleveland Clinic specifically for patients with desmoplastic small round cell tumors.↗
▶Ep 593 · 7:30
clinicalPediatric solid tumors have really high folate receptor expression, making them candidates for pafolacianine-based fluorescence-guided surgery.↗
▶Ep 593 · 7:30
quoteWe know pediatric solid tumors are really high in folates receptors. So we are going to have, I think, this is a really breakthrough story.↗
▶Ep 593 · 8:20
quoteThe subcomas don't highlight with ICG, and that's a problem.↗
▶Ep 593 · 8:20
clinicalSubcutaneous tumors do not highlight well with ICG, which is a known limitation of non-targeted fluorescence.↗
▶Ep 593 · 8:40
clinicalCurrent near-infrared fluorescence imaging only allows visualization of superficial tumors (approximately one centimeter depth), but newer molecules in development will allow deeper tissue penetration.↗
Summaries Gloria gave as host
· 1 summary
Recaps of what the experts said, with Gloria as narrator — not Gloria's own clinical position, and never cited in answers.
Summaries Gloria gave as host · Pediatric Oncology1 summary
2025 Pediatric Surgery Update Course - Updates in Oncology
▶Ep 593 · 8:05
host summaryGloria Gonzalez summarizing a resource: Pafolacianine is expensive and requires purchasing multiple vials for off-label use in pediatric patients.↗
