Diagnostic evaluation of sentinel lymph node biopsy using indocyanine green and infrared or fluorescent imaging in gastric cancer: a systematic review and meta-analysis

Skubleny, Daniel; Dang, Jerry; Skulsky, Samuel; Switzer, Noah; Tian, Chunjie; Shi, Xinzhe; Gara, Christopher de; Birch, Daniel W.; Karmali, Shahzeer

doi:10.1007/s00464-018-6100-9

Cited by 48 publications

(20 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfortunately, the individual lymphatic pattern is visually indistinguishable. In recent years, several strategies have been investigated aimed at intraoperatively visualizing the single-patient lymphatics' anatomy for surgical guidance, with ICG fluorescence emerging as the preferred method in many fields of cancer surgery [19,20,[31][32][33].…”

Section: Discussionmentioning

confidence: 99%

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

et al. 2022

View full text Add to dashboard Cite

Lymphadenectomy is crucial for an optimal oncologic resection of colon and rectal cancers. However, without a direct visualization, an aberrant route of lymph node (LN) diffusion might remain unresected. Indocyanine-green (ICG) lymphatic mapping permits a real-time LNs visualization. We designed the GREENLIGHT trial to explore in 100 patients undergoing robotic colorectal resection the clinical significance of a D3 ICG-guided lymphadenectomy. The primary endpoint was the number of patients in whom ICG changed the extent of lymphadenectomy. We report herein the interim analysis on the first 70 patients. After endoscopic ICG injection 24 h (n = 49) or 72 h (n = 21) ahead, 19, 20, and 31 patients underwent right colectomy, left colectomy, and anterior rectal resection. The extent of lymphadenectomy changed in 35 (50%) patients, mostly (29 (41.4%)) for the identification of LNs (median two) outside the standard draining basin. Identification of such LNs was less frequent in rectal tumors that had undergone chemoradiotherapy (26.3%) (p > 0.05). A non-significant correlation between time-to-ICG injection and identification of aberrant LNs was observed (48.9% at 24 h vs. 23.8% at 72 h). The presence of LN metastases did not affect a proper fluorescent mapping. These data indicate that ICG lymphatic mapping provides relevant information in 50% of patients, thus increasing the accuracy of potentially curative resections.

show abstract

Section: Discussionmentioning

confidence: 99%

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Skubleny et al recently published a meta-analysis of sentinel lymph node biopsy using indocyanine green and infrared or fluorescent imaging of gastric cancer. 46 The sensitivity of this meta-analysis was relatively low as 87% (0.80~0.93) in pooled analysis. The study also reported sensitivity of the studies using infrared electronic endoscopic as 97% and that of the studies using NIR fluorescent imaging systems as 72%.…”

Section: Future Of Node Navigation Using Nir Imagingmentioning

confidence: 67%

Near-Infrared Fluorescence Lymph Node Navigation Using Indocyanine Green for Gastric Cancer Surgery

Kong

Bae

Suh

et al. 2018

J Minim Invasive Surg

View full text Add to dashboard Cite

Near-infrared (NIR) fluorescence imaging is a promising method for image-guided surgery, providing robust functional images with relatively good cost-effectiveness. A cyanine vital dye indocyanine green (ICG) is a safe NIR fluorophore emitting 800~840 nm of light and has been used in numerous surgical procedures. The technique has been applied to lymph node navigation of gastric cancer surgery with an expectation of better visualization of lymphatic structures without any risk of radio-hazard compared with a "dual method" using both vital dyes and radioisotopes. Given the characteristics of ICG, such as fast distribution and quenching effect, diluted concentrations, such as 0.05~0.1 mg/ml, are thought to be optimal for sentinel node navigation. Injection into the subserosal layer is feasible; however, endoscopic submucosal injection has advantages of improved accuracy of the injection site and feasibility of injection one day prior to surgery; these advantages are preferred by some investigators due to a smaller number of sentinel nodes compared with injection in the operation theatre. The technology requires evaluation of the sensitivity and specificity, as well as the non-inferiority, compared with the dual method in a large cohort for justification as a safe node navigation method.

show abstract

“…Multiple studies have evaluated the safety and feasibility for sentinel node mapping in gastric cancer surgery [9,12]. The use of dual-tracer methods was found to be the most reliable to identify sentinel lymph nodes in gastric cancer [12][13][14].…”

Section: Discussionmentioning

confidence: 99%

“…If the absence of lymph node metastasis could be established by using a sentinel lymph node procedure, an unnecessary gastrectomy may be avoided. A recent meta-analysis concluded that sentinel node mapping with the use of indocyanine green (ICG) fluorescence imaging in gastric cancer is feasible with encouraging results in terms of detection rate, accuracy and sensitivity [9]. Most of the available literature studies are from Asia and make use of conventional laparoscopic techniques.…”

Section: Introductionmentioning

confidence: 99%

Robotic Sentinel Lymph Node Procedure After Endoscopic Submucosal Dissection of High Risk Early Gastric Cancer: A Case Report

Borgstein¹,

Eshuis²,

Gisbertz³

et al. 2020

IJCST

View full text Add to dashboard Cite

Endoscopic resection (ER) is the treatment of choice for early gastric cancer (T1) without lymph node involvement. An additional gastrectomy with D2 lymphadenectomy is recommended if ER is considered as non-curative. Here, we present a case of a robot-assisted sentinel lymph node procedure performed with the use of duel-tracer, including ICG fluorescence and technetium-99, after a non-curative ESD for an early gastric tumor. Five “hot” lymph nodes were resected, one of which was positive for metastasis. A subtotal gastrectomy with D2 lymphadenectomy was performed additionally during the same procedure. This case presentation indicates the feasibility of a robot-assisted sentinel lymph node procedure in early gastric cancer.

show abstract

Diagnostic evaluation of sentinel lymph node biopsy using indocyanine green and infrared or fluorescent imaging in gastric cancer: a systematic review and meta-analysis

Cited by 48 publications

References 48 publications

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

ICG-Guided Lymphadenectomy during Surgery for Colon and Rectal Cancer—Interim Analysis of the GREENLIGHT Trial

Near-Infrared Fluorescence Lymph Node Navigation Using Indocyanine Green for Gastric Cancer Surgery

Robotic Sentinel Lymph Node Procedure After Endoscopic Submucosal Dissection of High Risk Early Gastric Cancer: A Case Report

Contact Info

Product

Resources

About