Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence

Murawa, Dawid; Hirche, Christoph; Dresel, S.; Hünerbein, M.

doi:10.1002/bjs.6721

Cited by 211 publications

(145 citation statements)

References 31 publications

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“…Reliable methods for clinical detection of the SLN are in great demand to avoid unnecessary resection (29)(30)(31)(32)(33)(34). Indocyanine green is commonly used in SLN biopsies for different oncological procedures.…”

Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

“…Indocyanine green is commonly used in SLN biopsies for different oncological procedures. The metastatic status of regional lymph nodes is the most relevant prognostic factor in breast cancer, melanoma, and other solid organ tumors with a lymphatic spread (29)(30)(31)(32)(33)(34). The current gold standard for detection and targeted excision of the SLN is preoperative lymphoscintigraphy with technetium Tc 99m (29).…”

Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

“…Another study evaluated the feasibility of fluorescence detection of SLNs with ICG for lymphatic mapping and SLN biopsy for axillary staging in breast cancer (30)(31)(32). Thirty women with breast cancer received a periareolar injection of ICG for fluorescence detection of SLN with an NIR camera (30)(31)(32).…”

Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

“…Thirty women with breast cancer received a periareolar injection of ICG for fluorescence detection of SLN with an NIR camera (30)(31)(32). Another twenty received (99m)Tclabelled sulphur radiocolloid for SLN scintigraphy (30)(31)(32).…”

Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

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Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

Lavazza

Liu

et al. 2016

Gland Surg.

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Identification of the parathyroid glands during thyroid surgery may prevent their inadvertent surgical removal and thus provide a better postoperative quality of life. Nevertheless, the most common "technique" for intraoperative evaluation of perfusion of parathyroid gland tissues during thyroid surgery is visual inspection of the physical condition of tissues, e.g., their color and bleeding edges. Another technique is measurement of intact parathyroid hormone. Recently, indocyanine green-enhanced fluorescence has been used in various surgical techniques, particularly laparoscopic surgery, to improve visualization and to provide detailed anatomical information. Fluorescent optical guidance helps surgeons to avoid inadvertent tissue injury while enhancing procedural efficiency. This technique has potential use for evaluating perfusion of the parathyroid gland in real-time intraoperative angiography.

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Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

Section: Sentinel Lymph Node (Sln) Biopsymentioning

confidence: 99%

See 2 more Smart Citations

Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

Lavazza

Liu

et al. 2016

Gland Surg.

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“…This ability to control the level of echelon nodes excised may prove an advantage over other developing novel techniques for SLNB, such as indocynanine green (ICG) fluorescence, in which studies have demonstrated the mean number of excised SLNs ranging from 1.75-5.4 for the same volume of 1 mL ICG administered. [12,23,24] Clinically, more than 2 mL of magnetic tracer has not been used. Furthermore, the nodal saturation point in humans is likely to be higher than that in mini-pigs.…”

mentioning

confidence: 99%

160. Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model

Ahmed

Anninga

Pouw

et al. 2014

European Journal of Surgical Oncology (EJSO)

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The magnetic technique for sentinel lymph node biopsy (SLNB) has been evaluated in several clinical trials, albeit under proscribed conditions. An in vivo porcine model was therefore developed to optimise the magnetic technique by evaluating the effect of differing volume of magnetic tracer and time of injection. A total of 48 sentinel node procedures were undertaken and 423 nodes (109 sentinel nodes) retrieved. There was a significant correlation between magnetometer counts and the tracer content of excised sentinel lymph nodes (SLNs) (r=0.82; p<0.001). Total numbers of tracer-containing SLNs increased with increasing volumes of tracer (p<0.001). Transcutaneous magnetometer counts increased with increasing time from injection of tracer (p<0.0001) and reached a plateau within 60 minutes. A non-statistically significant trend was observed between volume of tracer injected and tracer content of SLNs (p=0.07). We infer that increasing tracer volume and injecting prior to surgery improves transcutaneous 'hotspot' identification, but that very high injection volumes lead to an increase in the number of nodes excised.3

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Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer

Schaafsma

Verbeek

Rietbergen

et al. 2013

British Journal of Surgery

135

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Background Combining radioactive colloids and a near-infrared (NIR) fluorophore permit preoperative planning and intraoperative localization of deeply located sentinel lymph nodes (SLNs) with direct optical guidance by a single lymphatic tracer. The aim of this clinical trial was to evaluate and optimize a hybrid NIR fluorescence and radioactive tracer for SLN detection in breast cancer patients. Method Patients with breast cancer undergoing SLN biopsy were enrolled. The day before surgery, indocyanine green (ICG)-99mTc-Nanocolloid was injected periareolarly and a lymphoscintigram was acquired. Directly before surgery, blue dye was injected. Intraoperative SLN localization was performed by a gamma probe and the Mini-FLARETM NIR fluorescence imaging system. Patients were divided into two dose groups, with one group receiving twice the particle density of ICG and nanocolloid, but the same dose of radioactive 99mTechnetium. Results Thirty-two patients were enrolled in the trial. At least one SLN was identified pre- and intraoperatively. All 48 axillary SLNs could be detected by gamma tracing and NIR fluorescence imaging, but only 42 of them stained blue. NIR fluorescence permitted detection of lymphatic vessels draining to the SLN up to 29 hours after injection. Increasing the particle density by two-fold did not yield a difference in fluorescence intensity, median 255 (range 98 – 542) vs. median 284 (90 – 921; P = 0.590), or signal- to- background ratio, median 5.4 (range 3.0 – 15.4) vs. median 4.9 (3.5 – 16.3; P = 1.000), of the SLN. Conclusion The hybrid NIR fluorescence and radioactive tracer ICG-99mTc-Nanocolloid permitted accurate pre- and intraoperative detection of the SLNs in patients with breast cancer.

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Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence

Abstract: ICG fluorescence allowed transcutaneous imaging of lymphatic vessels and SLN detection, thus combining the advantages of radioisotope and blue dye methods.

Cited by 211 publications

References 31 publications

Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

Indocyanine green-enhanced fluorescence for assessing parathyroid perfusion during thyroidectomy

160. Optimising magnetic sentinel lymph node biopsy in an in vivo porcine model

Clinical trial of combined radio- and fluorescence-guided sentinel lymph node biopsy in breast cancer

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