ICG Fluorescence Technique for the Detection of Sentinel Lymph Nodes in Breast Cancer: Results of a Prospective Open-label Clinical Trial

Grischke, Eva‐Maria; Röhm, C; Hahn, Markus; Helms, G; Brucker, Sara Y.; Wallwiener, D.

doi:10.1055/s-0035-1557905

Cited by 75 publications

(57 citation statements)

References 31 publications

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“…Coufal et al discussed an impact of BMI on ICG detection of SLNs, which depended on world region . Our study suggests that high BMI may impact on ICG SLN detection, as previously reported by Ayoma et al and Grischke et al Ayoma et al reported that a successful lymphatic drainage pathway was mapped in patients with a mean BMI of 22.3 kg/m 2 (range, 17.9‐33 kg/m 2 ) …”

Section: Discussionsupporting

confidence: 82%

Prospective evaluation of the limitations of near-infrared imaging in detecting axillary sentinel lymph nodes in primary breast cancer

et al. 2018

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We compared the performance of near-infrared imaging using indocyanine green (ICG) with the radioisotope (ISO) method to detect sentinel lymph nodes (SLNs) in breast cancer, to analyze predictive factors for negative ICG identification. The study included 122 patients who underwent sentinel lymph node biopsy (SLNB) using the combined ISO and ICG technique for primary breast cancer. We assessed the putative association between pathologic/clinical variables and ICG failure to detect SLNs. The ISO identification rate was 96.7% and ICG identification 81.9%.Overweight patients or presence of macrometastasis in SLNB were associated with the risk of ICG failing to detect SLNs (P = 0.02). K E Y W O R D Sbreast cancer, indocyanine green, sentinel lymph node, technetium, false negative

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Section: Discussionsupporting

confidence: 82%

Prospective evaluation of the limitations of near-infrared imaging in detecting axillary sentinel lymph nodes in primary breast cancer

et al. 2018

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“…Our assumption as to the crucial influence of depth of the detected structures on the success rate of visualization is supported also by the conclusions of several other studies. German authors have stated that body mass index (BMI) higher than 40 is a limiting factor for using ICG in breast cancer [29]. Although the highest BMI in our patient set reached only 30.9, it is apparent that deeper location of the SLNs in patients with a stronger subcutaneous layer complicates their fluorescent detection.…”

Section: Discussionmentioning

confidence: 73%

Use of indocyanine green and the HyperEye system for detecting sentinel lymph nodes in breast cancer within a population of European patients: a pilot study

Coufal

Fait

2016

World J Surg Onc

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BackgroundCertain studies suggest that using indocyanine green (ICG) could be comparable with using radioisotopes (RI) in detecting sentinel lymph nodes (SLNs) in breast cancer. A number of these studies were performed in Asia. The objective of our pilot study was to evaluate within a European population of breast cancer patients the detection rate of SLNs using ICG and the HyperEye system and the concordance in SLNs detected using this method and the standard method involving RI and a gamma probe.MethodsTen female patients with early-stage breast cancer (Czech Republic) indicated for partial mastectomy and SLN biopsy were subjected to standard application of RI. Before surgery, ICG was administered periareolarly in the amount of 1 ml of 0.5% solution. Sentinel lymph nodes were first detected perioperatively exclusively using ICG fluorescence and the HyperEye device (Mizuho, Japan). Only after removal of all SLNs found in this way was the standard hand-held gamma probe used to detect RI, and any potential additional SLNs not found with ICG were then extirpated.ResultsIn all 10 cases, at least one SLN was successfully detected using ICG. Nevertheless, in five patients, 1–4 additional SLNs were found using the gamma probe. Complete concordance in detecting SLNs therefore occurred in only one half of the cases. Metastases in SLNs were found in a total of two cases. Had we used only ICG for detection, one of these two cases would have been incorrectly evaluated as N0 (ICG false negativity).ConclusionsThe study did not confirm the hypothesis that the use of ICG with the HyperEye system can currently be considered a method fully comparable with using RI and a gamma probe in a population of European patients. Although the detection rate is high, a significantly lower number of SLNs were detected using ICG than using RI (p = 0.03). Thus, there would be a higher probability for false negatives to occur in using SLN biopsy. This is caused mainly by the limited permeability of tissues to fluorescent radiation and the difficulty therefore of detecting nodes located deeper beneath the body’s surface.

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“…This is the reason why the slightly enhanced costs of the surgical procedure have been considered as irrelevant. Considering data in the Literature, showing an equivalence in sensibility and specificity between the two methods [11][12][13][14][15][16][17][18], we have analyzed the economic impact of the two clinical pathways in the management of breast cancer.…”

Section: Methodsmentioning

confidence: 99%

Icg Versus 99tc in Breast Surgery-How to Match Quality Health Care and Costs Reduction: A Cost Effectiveness Study

Cattin¹,

Fogacci²,

Frisoni³

et al. 2017

J Cancer Sci Ther

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Introduction: Scientific evidence shows how ICG sensibility and specificity is comparable to 99Tc, and in many Breast Units ICG has become the gold standard for sentinel lymph node detection. Aim of this study is a cost-effectiveness analysis of the sentinel lymph node detection pathway using ICG, compared to the 99Tc one. Materials and methods:291 patients received a 99Tc injection the day before surgery and an ICG one in the OP day. As in our hospital a Nuclear Medicine Department does not exist, patients had to undergo an adjunctive travel in order to receive Technetium. We calculated costs of the whole Technetium procedure as like as the costs of the ICG one. Results:The overall amount of costs of the Technetium injection has been equal to 450363,62€. The ICG pathway has had an overall cost of 98668,7€, equal to a 21.9% of the Technetium expenses.Discussion: According to the Law, Technetium may be managed only in a Nuclear medicine department. This is the reason why Patients undergo a sometimes long travel to reach one. This traffic represents a cost for Patients and a work overload for the hospital structures. Indocyanine green allows to avoid a travel to the Nuclear Medicine and to spare a big amount of costs.

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ICG Fluorescence Technique for the Detection of Sentinel Lymph Nodes in Breast Cancer: Results of a Prospective Open-label Clinical Trial

Cited by 75 publications

References 31 publications

Prospective evaluation of the limitations of near-infrared imaging in detecting axillary sentinel lymph nodes in primary breast cancer

Prospective evaluation of the limitations of near-infrared imaging in detecting axillary sentinel lymph nodes in primary breast cancer

Use of indocyanine green and the HyperEye system for detecting sentinel lymph nodes in breast cancer within a population of European patients: a pilot study

Icg Versus 99tc in Breast Surgery-How to Match Quality Health Care and Costs Reduction: A Cost Effectiveness Study

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