Diagnostic accuracy of sentinel lymph node biopsy using indocyanine green in lung cancer: a systematic review and meta-analysis

Sun, Warren; Dang, Jerry; Modasi, Aryan; Nasralla, Awrad; Switzer, Noah; Birch, Daniel W.; Turner, Simon R.; Karmali, Shahzeer

doi:10.1007/s11748-020-01400-8

Cited by 10 publications

(6 citation statements)

References 37 publications

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“…Previously, ICG-NIR imaging was often used to detect sentinel lymph nodes in solid tumours, demonstrating that ICG was more effective than other tracers ( 18 ). For example, Kawakami et al ( 19 ) found that the identification rate of ICG-NIR imaging for sentinel lymph nodes in lung cancer surgery was as high as 72.7%, and the high accuracy rate of this technique could be maintained throughout the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

Chen

Tian

et al. 2023

Front. Surg.

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ObjectiveThis study aimed to investigate the feasibility of using indocyanine green (ICG) near-infrared (NIR) imaging during lymphadenectomy for oesophageal cancer.MethodsEighty-seven patients with primary oesophageal cancer were enrolled in this study. All the enrolled patients received an endoscopic injection of ICG between 40 min and 23 h before surgery. Nodal dissection during surgery was performed under fluorescence imaging visualisation, with the NIR signal shown in purple. ICG+ or ICG− nodes were recorded station by station and were microscopically evaluated.ResultsEndoscopic peritumoral ICG injection was successfully performed in all patients. Major post-surgery complications included wound infection, pleural effusion, dysphonia, pneumonia and anastomotic fistula. No patients experienced ICG-related adverse events. A total of 2,584 lymph nodes were removed, and the mean number of lymph nodes for each patient was 29.70 ± 9.24. Most of the removed nodes (97.83%) were ICG+, and 3.32% of the ICG+ nodes were metastatic. No metastatic nodes were ICG− or belonged to an ICG− lymph node station. The time from ICG injection to surgery did not affect the number of harvested lymph nodes.ConclusionsThe use of ICG-NIR imaging during oesophageal cancer surgery can enhance the visualisation of lymph nodes during surgery. It is a feasible, safe and helpful technique for lymphadenectomy.

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Section: Discussionmentioning

confidence: 99%

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

Chen

Tian

et al. 2023

Front. Surg.

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“…In lung cancer we have recently seen that more than 23.1% of clinical N0 patients are upstaged to N1 or N2 disease after surgical resection and pathological evaluation (69). SLN evaluation in lung cancer has been attempted over the last decades, but has shown difficult to implement in routine clinical practice (70,71). Further development in this field will be necessary to help improve survival of early-stage lung cancer.…”

Section: Future Perspectivesmentioning

confidence: 99%

Cone-beam CT in lung biopsy: a clinical practice review on lessons learned and future perspectives

Verhoeven¹,

Kops²,

Wijma³

et al. 2023

Ann Transl Med

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Pulmonary nodules with intermediate to high risk of malignancy should preferably be diagnosed with image guide minimally invasive diagnostics before treatment. Several technological innovations have been developed to endobronchially navigate to these lesions and obtain tissue for diagnosis. This review addresses these technological advancements in navigation bronchoscopy in three basic steps: navigation, position confirmation and acquisition, with a specific focus on cone-beam computed tomography (CBCT).For navigation purposes ultrathin bronchoscopy combined with virtual bronchoscopy navigation, electromagnetic navigation and robotic assisted bronchoscopy all achieve good results as a navigation guidance tool, but cannot confirm location or guide biopsy positioning. Diagnostic yield has seen improvement by combining these techniques with a secondary imaging tool like radial endobronchial ultrasound (rEBUS) and fluoroscopy. For confirmation of lesion access, rEBUS provides local detailed ultrasound-imaging and can be used to confirm lesion access in combination with fluoroscopy, measure nodule-contact area length and determine catheter position for sampling. CBCT is the only technology that can provide precise 3D positioning confirmation. When focusing on tissue acquisition, there is often more than 10% difference between reaching the target and getting a diagnosis. This discrepancy is multifactorial and caused by breathing movements, small samples sizes, instrument tip displacements by tool rigidity and tumour inhomogeneity. Yield can be improved by targeting FDG-avid regions, immediate feedback of rapid onsite evaluation, choosing sampling tools with different passive stiffnesses, by increasing the number biopsies taken and (future) catheter modifications like (robotic assisted-) active steering. CBCT with augmented fluoroscopy (CBCT-AF) based navigation bronchoscopy combines navigation guidance with 3D-image confirmation of instrument-in-lesion positioning in one device. CBCT-AF allows for overlaying the lesion and navigation pathway and the possibility to outline trans-parenchymal pathways. It can help guide and verify sampling in 3D in near real-time. Disadvantages are the learning curve, the inherent use of radiation and limited availability/access to hybrid theatres. A mobile C-arm can provide 3D imaging, but lower image quality due to lower power and lower contrast-to-noise ratio is a limiting factor. In conclusion, a multi-modality approach in experienced hands seems the best option for achieving a diagnostic accuracy >85%. Either adequate case selection or detailed 3D imaging are essential to obtain high accuracy. For current and future transbronchial treatments, high-resolution (CBCT) 3D-imaging is essential.

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“…In der Humanmedizin gilt als Standard für die präoperative Beurteilung der Lymphknoten die Positronen-Emissions-Tomographie (PET)/CT und/oder die endoskopisch- oder endobronchialultrasonographisch gestützte Feinnadelaspirationsbiopsie 41 , 42 , 43 . Die Indocyaningrün-Fluoroskopie ergab suboptimale Ergebnisse für die diagnostische Beurteilung der tributären Lymphknoten und ist somit für einen routinemäßigen klinischen Einsatz noch nicht geeignet 44 . Da diese Verfahren in der Veterinärmedizin noch nicht routinemäßig verfügbar sind, erfordert die Entwicklung eines zuverlässigen Protokolls für die präoperative Beurteilung der TBLN bei Hunden weitere Forschung.…”

Section: Diskussionunclassified

Klinisch-pathologische Befunde, postoperative Überlebenszeiten und prognostische Faktoren bei Hunden mit primären Lungenkarzinomen

Plavec¹,

Žagar²,

Kessler³

2022

Tierarztl Prax Ausg K Kleintiere Heimtiere

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Zusammenfassung Einleitung Primäre Karzinome der Lunge (PLK) beim Hund sind selten, ihre Behandlung erfolgt chirurgisch. Ziel dieser Studie war die Untersuchung klinisch-pathologischer Befunde, postoperativer medianer Überlebenszeiten (mÜZ) und prognostischer Faktoren. Material und Methoden Retrospektive Auswertung von 61 Hunden mit 62 PLK, die zwischen 2007 und 2017 chirurgisch behandelt wurden. Die statistische Auswertung erfolgte mittels Kaplan-Meier und Logrank Methoden. Ergebnisse Von 62 PLKs lagen 35 (56 %) peripher im Lungenlappen, 21 (34 %) hilusnah und 6 (10 %) betrafen den gesamten Lungenlappen. In 49 Fällen lagen differenzierte Adenokarzinome vor; niedrig differenzierte bzw. anaplastische Karzinome (n = 10) und Plattenepithelkarzinome (n = 2) waren deutlich seltener. Eine Prädisposition für bestimmte Lungenlappen war nicht nachzuweisen. Dreizehn (21 %) Patienten zeigten keine und 10 (16 %) nur unspezifische, nicht auf den Respirationstrakt hinweisende Symptome. Insgesamt zeigten 48 (79 %) Hunde klinische Symptome wie Husten, Dyspnoe, Lethargie, Gewichtsverlust, Leistungsschwäche, Erbrechen und/oder Fieber. Die tracheobronchialen Lymphknoten (TBLN) waren in 9 von 51 untersuchten Fällen histologisch positiv für Metastasierung (N1) und negativ (N0) in 42 Fällen (nicht untersucht n = 10). Daten zum Langzeitverlauf waren für 50 Patienten verfügbar. Prognostisch relevante Variablen waren Lymphknotenmetastasierung in die TBLN (mÜZ: N1 41 Tage, N0 570 Tage; p < 0,01), Lungenmetastasen (mÜZ: M1 125 Tage, M0 630 Tage; p < 0,01), histologischer Subtyp (mÜZ: differenzierte Karzinome 620 Tage; andere Karzinome 135 Tage; p < 0,01), Tumordurchmesser größer als 3 cm (mÜZ < 3 cm 1155 Tage, ≥ 3 cm 330 Tage; p = 0,02) und Tumorlokalisation (mÜZ: hilusnah 330 Tage, peripher 650 Tage; p = 0,04). Schlussfolgerung Beim PLK sind TBLN Status, Organmetastasen, Tumorlokalisation, histologischer Subtyp und Tumorgröße prognostisch relevante Kriterien. Hunde ohne prognostisch negative Faktoren können lange Überlebenszeiten aufweisen. In mehr als einem Drittel der Fälle bleiben die Tumoren asymptomatisch (21 %) bzw. ohne respirationstraktspezifische (16 %) Symptome.

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Diagnostic accuracy of sentinel lymph node biopsy using indocyanine green in lung cancer: a systematic review and meta-analysis

Cited by 10 publications

References 37 publications

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

Indocyanine green near-infrared imaging-guided lymph node dissection during oesophageal cancer surgery: A single-centre experience

Cone-beam CT in lung biopsy: a clinical practice review on lessons learned and future perspectives

Klinisch-pathologische Befunde, postoperative Überlebenszeiten und prognostische Faktoren bei Hunden mit primären Lungenkarzinomen

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