Intraoperative indocyanine green fluorescence guidance for excision of nonpalpable breast cancer

Liu, Jintao; Guo, Wenhui; Meng, Tong

doi:10.1186/s12957-016-1014-2

Cited by 22 publications

(40 citation statements)

References 28 publications

(36 reference statements)

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“…We also used the same method for the excision of NBCs in 56 patients and presented reviews of our experience. The results of INBCL in this study are similar to that of our series, in which we assessed margin clearance and the volume of the excised tissue with this technique . However, in the age of evidence‐based medicine, we found it necessary to perform a prospective, randomized trial comparing intra‐operative INBCL with the gold standard.…”

Section: Discussionsupporting

confidence: 74%

“…To date, an array of localization techniques is available, but the WL technique has become the standard means of localizing nonpalpable lesions. There are several disadvantages about it such as wire migration, displacement, patient discomfort, and poor aesthetic outcome . Radio‐guided occult lesion localization (ROLL) is most accurate (up to 94% clear margins) but is expensive, not universally available, and carries a risk associated with radioactive tracers …”

Section: Discussionmentioning

confidence: 99%

“…With the aid of developing technology, a novel method of using fluorescence imaging of indocyanine green (ICG) has been described . To date, only two reports have been described about it utilized as an adjunct to the excision of nonpalpable breast lesions …”

Section: Introductionmentioning

confidence: 99%

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Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Meng

Guo

2019

Breast J

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The use of wire localization (WL) for excisions of nonpalpable breast cancer (NBC) has several disadvantages. The purpose of this study was to evaluate the use of indocyanine green‐guided nonpalpable breast cancer lesion localization (INBCL) and to compare it with WL. A total of 62 patients with a preoperative histological diagnosis of NBC lesions that could be visualized with ultrasound and mammography were randomized to INBCL or WL. Patients with preoperatively diagnosed primary ductal carcinoma in situ and multifocal disease were excluded from the study. Significance was considered at P < 0.05. Of all 62 excision, 32 (51.6%) were guided by INBCL and 30 (48.4%) by WL. Both techniques resulted in 100% retrieval of the lesions. The rate of clear margins was significantly higher in the INBCL group (87.5%; 28/32) compared to the WL (63.3%, 19/30) (P = 0.026), reducing the requirement of re‐excision. When results of the excised tissue are taken into account, the mean volume of the INBCL specimen was 56 cm3 less than that of the WL group, although this was not significantly different (P = 0.058). INBCL for NBCs was more accurate than WL, because it optimized the surgeon's ability to obtain clear margins. A smaller volume of the tissue may be excised by using INBCL technique. Therefore INBCL is an attractive alternative to WL.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Meng

Guo

2019

Breast J

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“…In addition, it has an excellent safety profile for clinical use. On the other hand, this marker has the disadvantage of requiring a special camera, which increases costs and could limit its use in clinical practice 4,5 .…”

Section: Discussionmentioning

confidence: 99%

Use of dye in the preoperative marking of nonpalpable breast lesions literature review

Filho¹,

Moura²,

Gomes³

et al. 2019

Mastology

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Objetivo: Avaliar e comparar o uso de diferentes corantes na marcação de lesões não palpáveis de mama que possuem indicação para ressecção cirúrgica. Método: Foram analisadas as seguintes variáveis: número de casos, tipos de corante, técnica utilizada na marcação (azul patente, indocianina verde ou azul de metileno), técnicas associadas (fio-guia ou TC-99), margens livres do espécime cirúrgico (quando o diagnóstico era câncer), dor durante a marcação e eventos alérgicos. Organizou-se os principais resultados dos artigos em tabelas, utilizando o programa Microsoft Excel 2011. Resultados: Foram selecionados 11 artigos para análise. Ao todo, 510 mulheres realizaram marcação com corantes em 516 lesões impalpáveis de mama. Os principais corantes utilizados foram azul patente, azul de metileno e indocianina verde. A taxa de margens livres em casos de câncer foi de 95%. O azul de metileno foi superior aos demais corantes na obtenção de margens livres. Dos 11 artigos selecionados, em três foi feita a associação do corante com materiais radioativos, e em dois, com o fio guia. A dor durante a marcação foi analisada por dois estudos e classificada como moderada ou mínima por 75% das pacientes, sendo a mamografia o método mais associado à dor. Não foram reportados eventos alérgicos. Conclusão: O uso de corantes na marcação pré-operatória de lesões impalpáveis de mama é uma técnica viável, segura e mais barata. Os resultados iniciais de diversos grupos apontam vantagens significativas em relação aos métodos disponíveis atualmente. O azul de metileno apresenta menor taxa de margens comprometidas em relação aos demais corantes. Estudos prospectivos randomizados ainda são necessários para atestar a superioridade da técnica em relação às demais. ABSTRACTObjective: To evaluate and compare the use of different dyes in the marking of nonpalpable breast lesions indicated for surgical resection. Method: We analyzed the following variables: number of cases, types of dye, technique used for marking (patent blue, indocyanine green, or methylene blue), associated techniques (guidewire or Tc-99m), free margins of the surgical specimen (when the diagnosis was cancer), pain during the marking, and allergic events. The main results of the articles were organized in tables, using the software Microsoft Excel 2011. Results: We selected 11 articles for analysis. A total of 510 women had 516 nonpalpable breast lesions marked with dyes. The main dyes used were patent blue, methylene blue, and indocyanine green. The rate of free margins in cancer cases was 95%. Methylene blue was superior to other dyes in obtaining free margins. Out of the 11 articles selected, three associated dye with radioactive materials, and two with guidewire. Two studies analyzed the pain during the marking and revealed that 75% of the patients classified it as moderate or minimal, with mammography being the method most associated with pain. No allergic event was reported. Conclusion: The use of dyes in the preoperative marking of nonpalpable breast lesions is a viable, safe...

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“…Nearinfrared methods are most often used, where for example the fluorescent probe indocyanine green (ICG) remains the most commonly studied and utilised fluorophore for applications in fluorescence-guided surgery. ICG has demonstrated potential in various oncological applications through combination with endoscopic-based techniques such as laparoscopy 6 , as well as demonstrating its potential use in breast cancer margin estimation 7,8 . Despite success with ICG, near-infrared imaging techniques have not readily entered into clinical use due to the lack of appropriate contrast agents that have been FDA approved with current imaging technologies 9 .…”

Section: Introductionmentioning

confidence: 99%

NADPH as a potential intrinsic probe for tumour margin estimation

Stewart

Hupp

Birch

2018

Molecular-Guided Surgery: Molecules, Devices, and Applications IV

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The fluorescent properties of the reduced coenzyme NADH and its phosphorylated derivative (NADPH) have been explored in order to assess its potential as an intrinsic probe for cancer surgery. NADPH production is increased in cancer cells to quench reactive oxygen species and meet higher demands for biosynthesis, and has attractive fluorescent properties such as emission towards the visible part of the spectrum and a relatively long fluorescence lifetime upon binding to enzymes (~ 1 -6.5 ns) that help discriminate against other endogenous species. Different environmental effects on NAD(P)H fluorescence are reported here, including an increase in lifetime upon oxygen removal, an ability to retain its fluorescent properties in a silica phantom and its fluorescence lifetime also being distinguishable in a cell environment. In addition to this, the development of a miniaturised liquid light guide filter-based time-correlated single photon counting fluorescence lifetime system is reported as a step towards time-resolved visual imaging in cancer surgery. This system has been demonstrated as being capable of measuring NAD(P)H fluorescence lifetimes in both simple solvent and cell environments.

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Intraoperative indocyanine green fluorescence guidance for excision of nonpalpable breast cancer

Cited by 22 publications

References 28 publications

Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Indocyanine green fluorescence-guided lumpectomy of nonpalpable breast cancer versus wire-guided excision: A randomized clinical trial

Use of dye in the preoperative marking of nonpalpable breast lesions literature review

NADPH as a potential intrinsic probe for tumour margin estimation

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