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

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.

Technetium-99m-indocyanine green versus technetium-99m-methylene blue for sentinel lymph node biopsy in early-stage endometrial cancer

2020 ◽  
Vol 30 (3) ◽  
pp. 311-317 ◽  
Author(s):  
Silvia Cabrera ◽  
Vicente Bebia ◽  
Silvia Franco-Camps ◽  
Cristina Forcada ◽  
Diego Villasboas-Rosciolesi ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Endometrial Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Detection Rate ◽  
Early Stage ◽  
Detection Rates ◽  
Technetium 99M ◽  
Early Stage Endometrial Cancer

IntroductionThe low accuracy of pre-operative imaging techniques for prediction of nodal status strengthens the relevance of sentinel lymph node (SLN) biopsy in endometrial cancer, although the optimal method for its detection is still under investigation. The increasing use of indocyanine green (ICG) has aroused concern about its enhanced visualization of lymphatic channels, which could lead to a specimen that is thought to be nodal tissue not subsequently yielding a lymph node on pathologic analysis ('empty node packet'). Our main objective was to compare the overall and bilateral detection rates for SLN biopsy using two combined techniques: technetium-99m-ICG (Tc-99m-ICG) versus technetium-99m-methylene blue (Tc-99m-MB). Our secondary aim was to compare the ‘empty node packet’ rates between the two cohorts.MethodsA prospective, non-randomized, single-center trial including patients diagnosed with endometrial cancer (any grade or histology) in pre-operative early stage, and operated on between February 2017 and July 2019. All tracers were injected intracervically. Pelvic and aortic lymphadenectomy were performed on patients at intermediate or high risk of recurrence pre-operatively. All SLNs were sent for intra-operative frozen section and afterwards processed following an ultrastaging protocol.ResultsEighty-four patients were included, 58% (n=49) in the Tc-99m-MB group and 42% (n=35) in the Tc-99m-ICG group. Overall detection rate was 93% and was not statistically different between the two groups. A better bilateral detection rate was observed among Tc-99m-ICG patients (69% vs 41%, p=0.012). The 'empty node packet' rate was 4% in the Tc-99m-ICG cohort and 0% in the Tc-99m-MB cohort (p=0.032).DiscussionTc-99m-ICG is a feasible, safe technique for SLN biopsy in early-stage endometrial cancer, and appears to be superior in terms of bilateral detection to Tc-99m-MB. The addition of Tc-99m to ICG could decrease the rate of 'empty node packets' and better define the anatomic location of SLNs in patients with endometrial cancer.

Sentinel Lymphadenectomy in Vulvar Cancer Using Near-Infrared Fluorescence From Indocyanine Green Compared With Technetium 99m Nanocolloid

2017 ◽  
Vol 27 (4) ◽  
pp. 805-812 ◽  
Author(s):  
Philipp Soergel ◽  
Hermann Hertel ◽  
Anna Kaarina Nacke ◽  
Rüdiger Klapdor ◽  
Thorsten Derlin ◽  
...  
Keyword(s):  
Lymph Node ◽  
Confidence Interval ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Near Infrared ◽  
Vulvar Cancer ◽  
Sentinel Lymph Nodes ◽  
Infrared Band ◽  
Green Is ◽  
Patent Blue

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.

scholarly journals Biópsia do Gânglio Sentinela Guiada por Fluorescência no Cancro da Mama: Taxa de Deteção e Performance Diagnóstica

2018 ◽  
Vol 31 (12) ◽  
pp. 706
Author(s):  
Teresa Vaz ◽  
Susy Costa ◽  
Bárbara Peleteiro
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Detection Rate ◽  
Early Stage ◽  
Lymph Node Staging ◽  
Breast Cancer Patients ◽  
Detection Rates ◽  
Significant Difference

Introduction: Sentinel lymph node biopsy is currently the standard surgical procedure for lymph node staging in patients with early stage breast cancer. It is performed using different techniques, such as the injection of vital dyes and / or radioisotopes and, more recently, guided by fluorescence using Indocyanine green. The aim of this study is to assess the detection rate of sentinel lymph node using Indocyanine green in breast cancer patients according to factors related to the patient and the tumor.Material and Methods: Retrospective study of a random sample of patients with breast cancer, treated and followed at Centro Hospitalar São João, in Porto, between 2012 and 2016.Results: Indocyanine green detection rate was over 90% and its diagnostic accuracy was similar to other methods described in the presence of metastatic involvement of lymph nodes.Discussion: There was no statistically significant difference between the three methods in the detection rates in subgroups of older women, with normal weight and in those who underwent previous surgery in breast or axilla or neo-adjuvant chemotherapy.Conclusion: Indocyanine green is a potential alternative method to other sentinel lymph node screening techniques, appearing as a future option for breast cancer centers with no nuclear medicine department. However, it is essential to carry out further research in order to define the ideal patients’ profile that maximizes the method’s effectiveness.

Indocyanine-green-loaded microbubbles for localization of sentinel lymph node using near-infrared fluorescence/ultrasound imaging: a feasibility study

RSC Advances ◽  
2016 ◽  
Vol 6 (56) ◽  
pp. 50513-50520 ◽  
Author(s):  
Long Wang ◽  
Yihe Hu ◽  
Qinghai Peng ◽  
Jiawei Zhou ◽  
Qichang Zhou ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Radiation Exposure ◽  
Ultrasound Imaging ◽  
Feasibility Study ◽  
Cancer Metastasis ◽  
Near Infrared ◽  
False Negative ◽  
Near Infrared Fluorescence

Current strategies for sentinel lymph node (SLN) biopsy to detect cancer metastasis have some limitations such as the associated radiation exposure and high false-negative rates due to dye particles through the true SLNs to contiguous LNs.

scholarly journals Failure of Radiotracer Migration: Salvaging Sentinel Lymph Node Biopsy in Melanoma Care With Indocyanine Green

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110222
Author(s):  
Christine Nicholas ◽  
Carmen Webb ◽  
Claire Temple-Oberle
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Sentinel Node ◽  
Head And Neck ◽  
Near Infrared ◽  
False Negative ◽  
Lymph Node Biopsy ◽  
Blue Dye ◽  
Traditional Methods

Reducing false negative rates for sentinel lymph node biopsies (SLNB) in melanoma is important to accurately prognosticate and to guide treatment. Traditionally, SLNB has been performed with the adjunct of radiotracers and blue dye. Although sentinel node mapping is highly successful in axillary and inguinal node basins, identification of nodes in the head and neck is not as accurate with traditional methods. One reason for this may be failure of radiotracer migration. To augment standard technique using a radiocolloid, indocyanine green (ICG) combined with near infrared spectroscopy (NIRS), has shown promising results. We demonstrate a case of an individual undergoing SLNB in the head and neck region with failure of radiotracer migration. Identification of a sentinel node was accomplished with the use of ICG and NIRS. This technology offers an opportunity to salvage the SLNB when traditional methods fail.

Sign in / Sign up

Export Citation Format

Share Document