Lymph-Sparing Laparoscopic Palomo Varicocelectomy: Comparison Between Paratesticular Use of Patent Blue and Indocyanine Green in Teenagers

ObjectiveNowadays, sentinel diagnostic is performed using technetium 99m (99mTc) nanocolloid as a radioactive marker and sometimes patent blue. In the last years, indocyanine green has been evaluated for sentinel diagnostic in different tumor entities. Indocyanine green is a fluorescent molecule that emits a light signal in the near-infrared band after excitation. Our study aimed to evaluate indocyanine green compared with the criterion-standard99mTc-nanocolloid.MethodsWe included patients with primary, unifocal vulvar cancer of less than 4 cm with clinically node-negative groins in this prospective trial. Sentinel diagnostic was carried out using99mTc-nanocolloid, indocyanine green, and patent blue. We examined each groin for light signals from the near-infrared band, for radioactivity, and for blue staining. A sentinel lymph node was defined as a99mTc-nanocolloid–positive lymph node. All sentinel lymph nodes and all additional blue or fluorescent lymph nodes were excised and tested and then sent for histologic examination.ResultsIn all, 27 patients were included in whom we found 91 sentinel lymph nodes in 52 groins. All these lymph nodes were positive for indocyanine green, also giving a sensitivity of 100% (95% confidence interval [CI], 96.0%–100%) compared with99mTc-nanocolloid. Eight additional lymph nodes showed indocyanine green fluorescence but no99mTc positivity, so that the positive predictive value was 91.9% (95% confidence interval, 84.6%–96.5%). In 1 patient, a false-negative sentinel missed by all 3 modalities was found.ConclusionsOur results show that indocyanine green is a promising approach for inguinal sentinel identification in vulvar cancer with a similar sensitivity as radioactive99mTc-nanocolloid and worth to be evaluated in further studies.

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Randomized Comparison of Near-infrared Fluorescence Imaging Using Indocyanine Green and 99m Technetium With or Without Patent Blue for the Sentinel Lymph Node Procedure in Breast Cancer Patients

Annals of Surgical Oncology ◽

10.1245/s10434-012-2466-4 ◽

2012 ◽

Vol 19 (13) ◽

pp. 4104-4111 ◽

Cited By ~ 81

Author(s):

Joost R. van der Vorst ◽

Boudewijn E. Schaafsma ◽

Floris P. R. Verbeek ◽

Merlijn Hutteman ◽

J. Sven D. Mieog ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Sentinel Lymph Node ◽

Indocyanine Green ◽

Cancer Patients ◽

Near Infrared ◽

Breast Cancer Patients ◽

Sentinel Lymph Node Procedure ◽

Patent Blue ◽

Near Infrared Fluorescence Imaging

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Exploratory Study of the Clinical Value of Near-Infrared Sentinel Lymph Node Mapping With Indocyanine Green in Vulvar Cancer Patients

Frontiers in Oncology ◽

10.3389/fonc.2021.652458 ◽

2021 ◽

Vol 11 ◽

Author(s):

Franziska Siegenthaler ◽

Sara Imboden ◽

Laura Knabben ◽

Stefan Mohr ◽

Andrea Papadia ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Indocyanine Green ◽

Detection Rate ◽

Near Infrared ◽

Vulvar Cancer ◽

Clinical Value ◽

Detection Rates ◽

Technetium 99M ◽

Patent Blue

BackgroundThis study aimed to evaluate the clinical value of indocyanine green sentinel lymph node (SLN) mapping in patients with vulvar cancer. The conventional procedure of SLN mapping in vulvar cancer includes peritumoral injection of technetium-99m nanocolloid before surgery and intraoperative injection of a blue dye. However, these techniques harbor some limitations. Near-infrared fluorescence imaging with indocyanine green has gained popularity in SLN mapping in different types of cancer.MethodsWe analyzed retrospectively vulvar cancer patients at our institution between 2013 and 2020 undergoing indocyanine green SLN mapping by applying video telescope operating microscope system technology.Results64 groins of 34 patients were analyzed. In 53 groins we used technetium-99m nanocolloid, in four patent blue, and in five both techniques, additionally to indocyanine green for SLN detection. In total, 120 SLNs were identified and removed. The SLN detection rate of indocyanine green was comparable to technetium-99m nanocolloid (p=.143) and higher than patent blue (p=.003). The best results were achieved using a combination of ICG and technetium-99m nanocolloid (detection rate of 96.9%). SLN detection rates of indocyanine green were significantly higher in patients with positive lymph nodes (p=.035) and lymphatic space invasion (p=.004) compared to technetium-99m nanocolloid.ConclusionIndocyanine green SLN mapping in vulvar cancer is feasible and safe, with reasonable detection rates. Due to its easy application and few side effects, it offers a sound alternative to the conventional SLN mapping techniques in vulvar cancer. In patients with lymph node metastasis, indocyanine green even outperformed technetium-99m nanocolloid in terms of detection rate.

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156 Sentinel lymph node detection with indocyanine green and patent blue dye in cervical cancer: a retrospective study

10.1136/ijgc-2020-igcs.135 ◽

2020 ◽

Author(s):

R McBain ◽

O McNally ◽

D Neesham ◽

A Jones ◽

A Richards

Keyword(s):

Cervical Cancer ◽

Lymph Node ◽

Retrospective Study ◽

Sentinel Lymph Node ◽

Indocyanine Green ◽

Blue Dye ◽

Sentinel Lymph Node Detection ◽

Patent Blue ◽

Patent Blue Dye

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Patent blue V and indocyanine green for fluorescence microimaging of human peritoneal carcinomatosis using probe-based confocal laser endomicroscopy

Surgical Endoscopy ◽

10.1007/s00464-016-4873-2 ◽

2016 ◽

Vol 30 (12) ◽

pp. 5255-5265 ◽

Cited By ~ 2

Author(s):

Muriel Abbaci ◽

Peggy Dartigues ◽

Frederic De Leeuw ◽

Ranya Soufan ◽

Monique Fabre ◽

...

Keyword(s):

Indocyanine Green ◽

Peritoneal Carcinomatosis ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Patent Blue ◽

Patent Blue V

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Enhanced type I photoreaction of indocyanine green via electrostatic-force-driven aggregation

Nanoscale ◽

10.1039/d0nr01208d ◽

2020 ◽

Vol 12 (17) ◽

pp. 9517-9523 ◽

Cited By ~ 3

Author(s):

Huizhen Fan ◽

Yu Fan ◽

Wenna Du ◽

Rui Cai ◽

Xinshuang Gao ◽

...

Keyword(s):

Mesoporous Silica ◽

Indocyanine Green ◽

Electrostatic Force ◽

Type I ◽

Positively Charged

ICG forms aggregates in positively charged mesoporous silica, which show an enhanced type I photoreaction pathway.

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Initial experience with a new quantitative assessment tool for fluorescent imaging in peripheral artery disease

VASA ◽

10.1024/0301-1526/a000642 ◽

2017 ◽

Vol 46 (5) ◽

pp. 383-388 ◽

Cited By ~ 6

Author(s):

Henrik Christian Rieß ◽

Anna Duprée ◽

Christian-Alexander Behrendt ◽

Tilo Kölbel ◽

Eike Sebastian Debus ◽

...

Keyword(s):

Indocyanine Green ◽

Quantitative Assessment ◽

Tissue Perfusion ◽

Fluorescent Imaging ◽

Peripheral Artery ◽

Peripheral Bypass ◽

Before And After ◽

Artery Disease ◽

Green Fluorescent ◽

Peripheral Bypass Grafting

Abstract. Background: Perioperative evaluation in peripheral artery disease (PAD) by common vascular diagnostic tools is limited by open wounds, medial calcinosis or an altered collateral supply of the foot. Indocyanine green fluorescent imaging (ICG-FI) has recently been introduced as an alternative tool, but so far a standardized quantitative assessment of tissue perfusion in vascular surgery has not been performed for this purpose. The aim of this feasibility study was to investigate a new software for quantitative assessment of tissue perfusion in patients with PAD using indocyanine green fluorescent imaging (ICG-FI) before and after peripheral bypass grafting. Patients and methods: Indocyanine green fluorescent imaging was performed in seven patients using the SPY Elite system before and after peripheral bypass grafting for PAD (Rutherford III-VI). Visual and quantitative evaluation of tissue perfusion was assessed in an area of low perfusion (ALP) and high perfusion (AHP), each by three independent investigators. Data assessment was performed offline using a specially customized software package (Institute for Laser Technology, University Ulm, GmbH). Slope of fluorescent intensity (SFI) was measured as time-intensity curves. Values were compared to ankle-brachial index (ABI), slope of oscillation (SOO), and time to peak (TTP) obtained from photoplethysmography (PPG). Results: All measurements before and after surgery were successfully performed, showing that ABI, TTP, and SOO increased significantly compared to preoperative values, all being statistically significant (P < 0.05), except for TTP (p = 0.061). Further, SFI increased significantly in both ALP and AHP (P < 0.05) and correlated considerably with ABI, TTP, and SOO (P < 0.05). Conclusions: In addition to ABI and slope of oscillation (SOO), the ICG-FI technique allows visual assessment in combination with quantitative assessment of tissue perfusion in patients with PAD. Ratios related to different perfusion patterns and SFI seem to be useful tools to reduce factors disturbing ICG-FI measurements.

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