Novel Indocyanine Green–Phytate Colloid Technique for Sentinel Node Detection in Head and Neck: Mouse Study

Araki, Koji; Mizokami, Daisuke; Tomifuji, Masayuki; Yamashita, Taku; Ohnuki, Kazunobu; Umeda, Izumi O.; Fujii, Hirofumi; Kosuda, Shigeru; Shiotani, Akiko

doi:10.1177/0194599814530409

Cited by 10 publications

(10 citation statements)

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“…To overcome this drawback, the authors demonstrated a technique of a mixture of ICG with phytate colloid. This technique allows a prolonged diagnostic time window, the prevention of downstream subsequent nodes detection, and improved accuracy for the detection of true SNs in a nude mouse model, and the clinical application of this technique is promising.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive surgery for laryngopharyngeal cancer: Multicenter feasibility study of a combination strategy involving transoral surgery and real‐time indocyanine green fluorescence‐navigated sentinel node navigation surgery

et al. 2019

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Background: Sentinel node navigation surgery using indocyanine green (ICG-SNNS) can be performed in the operation room. The combination of minimally invasive transoral surgery (TOS) with ICG-SNNS can provide functional preservation options for both primary lesions and lymph node (LN) metastasis. This multicenter feasibility study of this strategy was conducted in Japan. Methods: Patients with clinical T1 or T2, N0 oropharyngeal, hypopharyngeal, or supraglottic cancer were enrolled. The identification rate of sentinel nodes, delayed cervical LN metastasis in 2 years, and survival rate were assessed. Results: Twenty-two patients (10 oropharynx, 8 hypopharynx, 4 supraglottic cancer) were enrolled. The identification rate was 100%. One case had delayed nodal metastasis. The accuracy was 95.5%, sensitivity was 75%, and specificity was 100%. The 5-year disease-specific survival was 100%, overall survival was 72.3%, and disease-free survival was 60.5%. Conclusions: The combination of TOS with ICG-SNNS is feasible as a minimally invasive strategy and has favorable oncological outcomes. K E Y W O R D Sindocyanine green, laryngeal cancer, pharyngeal cancer, sentinel lymph node, transoral surgery A part of this research was presented at

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Section: Discussionmentioning

confidence: 99%

Minimally invasive surgery for laryngopharyngeal cancer: Multicenter feasibility study of a combination strategy involving transoral surgery and real‐time indocyanine green fluorescence‐navigated sentinel node navigation surgery

et al. 2019

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“…The exact detection of SNs with ICG mapping requires a sufficient learning curve. Araki et al (33), resolved this problem by mixing ICG with phytate colloid to retard its migration and demonstrated the feasibility of this technique in a nude mouse study.…”

Section: Cases Nodes ------------------------------------------------mentioning

confidence: 99%

Long term‑follow‑up multicenter feasibility study of ICG fluorescence‑navigated sentinel node biopsy in oral cancer

et al. 2020

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In the current study, the utility of sentinel node (SN) identification using indocyanine green (ICG) was investigated for oral cancers in the clinical N0 stage. The current study was a prospective, multicentre, phase II clinical trial that was conducted in Japan. A total of 18 patients were included. Before surgery, the patients underwent lymphoscintigraphy to map the SNs. During surgery, radioactive isotope (RI) mapping was used to detect the SNs, and ICG was subsequently injected. ICG mapping of the SNs was then performed through the skin. The primary tumour was resected, and a neck flap was elevated for neck dissection, followed by SN biopsy (SNB) using RI or ICG mapping. With the RI method, a total of 63 SNs were detected. Among these SNs, 8 (12.7%) were positive for metastasis, including those with isolated tumour cells (ITCs). The median number of SNs per patient identified by SNB was 4. With the ICG method, a total of 67 SNs were detected. Among these SNs, 7 (10.4%) were positive for metastasis, including those with ITCs. The median number of SNs per patient identified by SNB was 4 (range, 1-6). The 5-year overall survival (OS) of all patients was 83.3%, and the 5-year disease-free survival (DFS) of all patients was 76.7%. The neck compression technique is a simple method that can be used to facilitate surgical procedures of ICG fluorescence navigated SNB for head and neck cancer.

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“…Similarly, the separate administration of immunogenically modified liposome and pentameric immunoglobulin M in a rat model resulted in their aggregation and retention in LN for prolonged periods of time 32 . Araki et al also mentioned that small phytate colloidal particles (100–200 nm in diameter) migrate immediately after their injection into LN, where they increase in size upon reacting with ionized calcium and are retained for much longer periods without passing to the downstream nodes 24 . However, they did not investigate the detailed particle profile of phytate colloid mixed with ICG.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, Araki et al 24 reported that, in an animal model, the addition of phytate colloid to ICG significantly prolonged the retention of fluorescence in primary LNs and retarded its migration to downstream nodes. However, they did not analyze the mixture’s particle profile; The use of phytate colloid for visceral organs is tricky because it reportedly accumulates heavily in the liver 24 and behaves differently in rodents and primates 25 . Therefore, we tested the utility of the SnC and ICG mixture (SnC–ICG), both approved by the Pharmaceuticals and Medical Devices Agency in Japan for the detection of SLN.…”

Section: Introductionmentioning

confidence: 99%

Stannous colloid mixed with indocyanine green as a tracer for sentinel lymph node navigation surgery

Zhang

Uehara

Toyota

et al. 2022

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The combined use of a vital dye and radioactive colloid reportedly performs better in detecting sentinel lymph nodes (SLNs) for cancers than the use of either of them alone. However, especially for gastric cancer, two endoscopic procedures are required to administer these two tracers, which burdens the patients and practitioners. Here we propose the use of stannous colloid (SnC) mixed with indocyanine green (ICG) as a new mixed tracer (SnC–ICG); its characteristics were investigated in vivo and in vitro to estimate its usefulness for SLN navigation. The tracers were administered to rats and the accumulation of radioactivity and/or near-infrared fluorescence were evaluated in the regional lymph nodes (LNs) using single positron emission computed tomography and near-infrared fluorescence imaging, respectively. SnC–ICG showed significantly better clearance from the injection site and better migration to primary LNs than the single administration of SnC or ICG aqueous solution. SnC–ICG demonstrated a wide particle size variability, stabilized to 1200-nm upon the addition of albumin in vitro; These properties could contribute to its behavior in vivo. The use of SnC–ICG could contribute better performance to detect SLNs for gastric cancer with less burden on both patients and medical practitioners.

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Novel Indocyanine Green–Phytate Colloid Technique for Sentinel Node Detection in Head and Neck: Mouse Study

Abstract: This novel technique of ICG-phytate colloid mixture allows prolonged diagnostic time window, prevention of downstream subsequent nodes detection, and improved accuracy for the detection of true sentinel lymph nodes.

Cited by 10 publications

References 38 publications

Minimally invasive surgery for laryngopharyngeal cancer: Multicenter feasibility study of a combination strategy involving transoral surgery and real‐time indocyanine green fluorescence‐navigated sentinel node navigation surgery

Minimally invasive surgery for laryngopharyngeal cancer: Multicenter feasibility study of a combination strategy involving transoral surgery and real‐time indocyanine green fluorescence‐navigated sentinel node navigation surgery

Long term‑follow‑up multicenter feasibility study of ICG fluorescence‑navigated sentinel node biopsy in oral cancer

Stannous colloid mixed with indocyanine green as a tracer for sentinel lymph node navigation surgery

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