Comparison of the Indocyanine Green Fluorescence and Blue Dye Methods in Detection of Sentinel Lymph Nodes in Early-stage Breast Cancer

Sugie, Tomoharu; Sawada, Terumasa; Tagaya, Nobumi; Kinoshita, Takayuki; Yamagami, Keiko; Suwa, Hirofumi; Ikeda, Takafumi; Yoshimura, Kenichi; Niimi, Miyuki; Shimizu, Akira; Toi, Masakazu

doi:10.1245/s10434-013-2890-0

Cited by 137 publications

(86 citation statements)

References 30 publications

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“…To this end, recently, ICG that can be displayed simultaneously and has a good lymphatic drainage has been used for SLNB in breast cancer. Similar to this study, Murawa et al (22) reported no (24) reported the SLN detection rate as 78% with use of blue dye as compared to the 99% with ICG use. In the same study, difference of the median number of SLNs detected by the two methods was as one more in the ICG method than blue dye method.…”

Section: Discussionsupporting

confidence: 84%

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

Aydoğan

Arıkan

Aytaç

et al. 2016

UCD

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Objective: Sentinel lymph node biopsy can be applied by using either blue dye or radionuclide method or both in breast cancer. Fluorescent imaging with indocyanine green is a new defined method. This study evaluates the applicability of sentinel lymph node biopsy via fluorescent indocyanine green.Material and Methods: IC-VIEW (Pulsion Medical Systems AG, Munich, Germany) infrared visualization system was used for imaging. Two mL of indocyanine green was injected to visualize sentinel lymph nodes. After injection, subcutaneous lymphatics were traced and sentinel lymph nodes were found with simultaneous imaging. Sentinel lymph nodes were excised under fluorescent light guidance, and excised lymph nodes were examined histopathologically. Patients with sentinel lymph node metastases underwent axillary dissection.Results: Four patients with sentinel lymph node biopsy due to breast cancer were included in the study. Sentinel lymph nodes were visualized with indocyanine green in all patients. The median number of excised sentinel lymph node was 2 (2-3). Two patients with lymph node metastasis underwent axillary dissection. No metastasis was detected in lymph nodes other than the sentinel nodes in patients with axillary dissection. There was no complication during and after the operation related to the method. Conclusion:According to our limited experience, sentinel lymph node biopsy under fluorescent indocyanine green guidance, which has an advantage of simultaneous visualization, is technically feasible.

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Section: Discussionsupporting

confidence: 84%

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

Aydoğan

Arıkan

Aytaç

et al. 2016

UCD

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“…It has been used alone or in combination with blue dye or radioisotope [18,19,20,21,22]. The published studies use a wide range of ICG doses, and standardisation in terms of concentration and volume injected is vital.…”

Section: Fluorescence Techniquesmentioning

confidence: 99%

New Technologies for Sentinel Lymph Node Detection

Goyal¹

2018

Breast Care

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The ‘standard of care' method for sentinel node mapping is the combination technique using radioisotope and blue dye although some centres use radioisotope or blue dye alone. Radioisotope usage requires licensing, has regulatory issues around handling and disposal of waste, and logistically may be unavailable or difficult to implement in some centres or less developed country. This has led to the development of alternative methods such as superparamagnetic iron oxide (SPIO), fluorescence techniques using indocyanine green (ICG) or fluorescein, computed tomography lymphography, and contrast-enhanced ultrasound scan (CEUS) using microbubbles. The newer techniques will potentially enable a more widespread adoption of this procedure; however, a common barrier for these techniques is the lack of standardisation and no randomised trials to evaluate their effectiveness against the current standard of care. Furthermore, many of these techniques are more costly and may become redundant in node-negative patients with small tumours if ongoing trials show that sentinel node biopsy offers no additional benefit to grey-scale axillary ultrasound. This review discusses the new techniques for sentinel node mapping that have emerged including their pros and cons.

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“…Fluorescent ICG has frequently been used as an alternative to dyes or radioactive gamma probes to guide sentinel lymph node biopsy (58)(59)(60). Fluorescent molecules offer the advantages of ease of use ease of use and low invasiveness compared to methods requiring exposure to radiation (58).…”

Section: Fluorescent Imaging Of the Lymphaticsmentioning

confidence: 99%

“…ICG was effectively used as a surgical guide to accurately detect and remove axillary sentinel lymph nodes (58). Sentinel nodes were more likely to be identified by the fluorescence method than the blue dye method (60). Improved accuracy of sentinel lymph node biopsy allows the sparing of healthy nodes and potentially of the healthy portions of nodes partially invaded by metastasis, reducing the risk of post-surgical lymphedema.…”

Section: Fluorescent Imaging Of the Lymphaticsmentioning

confidence: 99%

Advances in fluorescent-image guided surgery

2016

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Comparison of the Indocyanine Green Fluorescence and Blue Dye Methods in Detection of Sentinel Lymph Nodes in Early-stage Breast Cancer

Abstract: High rate of SLN detection was achieved using the ICG fluorescence method. The first SLN identified by fluorescence imaging provides an exact indication of the axillary status. Therefore, the ICG fluorescence method provides precise information required to avoid unnecessary ALND.

Cited by 137 publications

References 30 publications

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

Sentinel lymph node biopsy under fluorescent indocyanin green guidance: Initial experience

New Technologies for Sentinel Lymph Node Detection

Advances in fluorescent-image guided surgery

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