Sentinel Node Mapping Guided by Indocyanine Green Fluorescence Imaging During Laparoscopic Surgery in Gastric Cancer

Tajima, Yusuke; Murakami, Masahiko; Yamazaki, Kaoru; Masuda, Yuki; Kato, Masanori; Satō, Atsushi; Goto, Satoru; Otsuka, Koji; Kato, Takashi; Kusano, Mitsuo

doi:10.1245/s10434-010-0944-0

Cited by 116 publications

(97 citation statements)

References 32 publications

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“…That study yielded favorable results from the technique, which showed high accuracy [7]. In cases without SN metastasis, minimized gastrectomy with limited lymphadenectomy can be performed [8,9].…”

Section: Introductionmentioning

confidence: 76%

“…Furthermore, 2.0 ml of RI tracer were injected into the quadrants of the submucosal layer around the tumor using an endoscopic puncture needle. While under general anesthesia and before surgery, 2 ml of 0.5 % indocyanine green solution (dye tracer) were injected in the same manner [9]. We diagnosed lymph nodes that were positive for either indocyanine green (ICG) staining or RI tracer as SNs.…”

Section: Sn Biopsy and Mapping Techniquesmentioning

confidence: 99%

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Auxiliary diagnosis of lymph node metastasis in early gastric cancer using quantitative evaluation of sentinel node radioactivity

et al. 2015

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Background Sentinel node (SN) mapping using dye and radioisotope (RI) tracer has been reported to be feasible in cases of early gastric cancer. Because accurate diagnosis of micrometastasis is sometimes difficult in the limited time available during surgery, a faster and simpler method of improving the intraoperative diagnostic precision of lymph node metastasis is needed. The amount of tracer deposited in an SN can be determined from its radioactivity; however, the significance of the RI count has not been fully discussed. We investigated the clinical impact of the RI count when used as an adjunct to conventional lymph node dissection when diagnosing lymphatic metastasis in cases of early gastric cancer. Methods From 2008 to 2009, patients with clinically diagnosed T1N0M0 gastric cancers who underwent gastrectomy and SN mapping were enrolled. SNs were examined by intraoperative and postoperative pathology. The RI count was measured for each SN with a handheld gamma probe; the correlation between nodal metastasis and the RI count was assessed. Results A total of 308 SNs were harvested from 72 patients. Patients with SN metastasis had significantly higher total RI counts than those without SN metastasis (p = 0.007). Among cases with SN metastasis, RI counts were also significantly elevated in metastasis-positive nodes, stations, and basins. In these cases, the most of SNs having the highest RI count in each case had metastasis including isolated tumor cells. Conclusion In early gastric cancer patients, a high RI count from an SN was correlated with lymph node metastasis. Therefore, RI counting may aid efficient pathological diagnosis and focused lymph node dissection.

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Section: Introductionmentioning

confidence: 76%

Section: Sn Biopsy and Mapping Techniquesmentioning

confidence: 99%

Auxiliary diagnosis of lymph node metastasis in early gastric cancer using quantitative evaluation of sentinel node radioactivity

et al. 2015

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“…These recommended doses of ICG administrated in adults correspond to 1.15-5.16 μM of ICG concentration in the brain tissue. Furthermore, it can be found in earlier publications that the typical ICG dose per measurement used in in-vivo experiments does not exceed 20 mg (corresponding to 2.58 μM concentration of ICG in the brain) [26,27,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59]. However it can be also found that some groups used 25 mg (3.83 μM in the brain) in a single dose [60][61][62][63][64] and even higher doses of ICG 0.5 mg/kg were reported in studies on humans [65][66][67].…”

Section: Discussionmentioning

confidence: 99%

Neurotoxic effects of indocyanine green -cerebellar granule cell culture viability study

Toczyłowska

Ziemińska

Goch

et al. 2014

Biomed. Opt. Express

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Abstract:The aim of this study was to examine neurotoxicity indocyanine green (ICG). We assessed viability of primary cerebellar granule cell culture (CGC) exposed to ICG to test two mechanisms that could be the first triggers causing neuronal toxicity: imbalance in calcium homeostasis and the degree of oligomerization of ICG molecules. We have observed this imbalance in CGC after exposure to 75-125μΜ ICG and dose and application sequence dependent protective effect of Gadovist on surviving neurons in vitro when used with ICG. Spectroscopic studies suggest the major cause of toxicity of the ICG is connected with oligomers formation. ICG at concentration of 25 μM (which is about 4 times higher than the highest concentration of ICG in the brain applied in in-vivo human studies) is not neurotoxic in the cell culture. Orlock, and C. A. Puliafito, "Adverse reactions due to indocyanine green," Ophthalmology 101(3), 529-533 (1994). 2. B. F. Hochheimer, "Angiography of the retina with indocyanine green," Arch. Ophthalmol. 86(5), 564-565 (1971). 3. J. Fishbaugh, "Retina: indocyanine green (ICG) angiography," Insight 19(3), 30-32 (1994). 4. J. Caesar, S. Shaldon, L. Chiandussi, L. Guevara, and S. Sherlock, "The use of indocyanine green in the measurement of hepatic blood flow and as a test of hepatic function," Clin. Sci. 21, 43-57 (1961). 5. A. El-Desoky, A. M. Seifalian, M. Cope, D. T. Delpy, and B. R. Davidson, "Experimental study of liver dysfunction evaluated by direct indocyanine green clearance using near infrared spectroscopy," Br. J. Surg. 1005-1011 (1999). 6. T. Ishizawa, N. Fukushima, J. Shibahara, K. Masuda, S. Tamura, T. Aoki, K. Hasegawa, Y. Beck, M. Fukayama, and N. Kokudo, "Real-time identification of liver cancers by using indocyanine green fluorescent imaging," Cancer 115(11), 2491-2504 (2009 4998-5003 (2006). 17. T. L. Jackson, "Indocyanine green accused," Br. J. Ophthalmol. 89(4), 395-396 (2005). Reson. Imaging 14(6), 619-623 (1996). 77. D. E. Ray, J. B. Cavanagh, C. C. Nolan, and S. C. Williams, "Neurotoxic effects of gadopentetate dimeglumine: behavioral disturbance and morphology after intracerebroventricular injection in rats," AJNR Am. J. Neuroradiol. 17(2), 365-373 (1996). 78. X. Feng, Q. Xia, L. Yuan, X. Yang, and K. Wang, "Impaired mitochondrial function and oxidative stress in rat cortical neurons: implications for gadolinium-induced neurotoxicity," Neurotoxicology 31(4), 391-398 (2010). 79. M. P. Mattson and Y. Goodman, "Different amyloidogenic peptides share a similar mechanism of neurotoxicity involving reactive oxygen species and calcium," Brain Res. 676(1), 219-224 (1995). 86(8),

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“…1). The amount injected also seemed to be sufficient at 0.2 ml, which is an amount approximately 100 times smaller than the conventional amount of ICG used in the vital dye method (5 mg/ml and 0.5 ml) [21,32,33]. A smaller dose could be less toxic for a hypersensitivity reaction, a rare event for ICG, and also more specific because ICG at a greater dose spreads widely into multiple lymphatic flows [34].…”

Section: Discussionmentioning

confidence: 93%

Evaluation of the novel near-infrared fluorescence tracers pullulan polymer nanogel and indocyanine green/γ-glutamic acid complex for sentinel lymph node navigation surgery in large animal models

et al. 2014

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Background This study aimed to examine tracers designed to overcome the disadvantages of indocyanine green (ICG), which disperses quickly to multiple lymph nodes, using a near-infrared (NIR) imaging system in animal models. Methods Diluted ICG, ICG/poly-c-glutamic acid (PGA) complex, and IRDye900-conjugated pullulan-cholesterol nanoprobe ''near-infrared polynagogel'' (NIR-PNG) were injected into the stomachs of dogs and pigs, and the patterns of dispersion were observed using an NIR imaging system. To compare retention times, fluorescence signals were evaluated in the stomach and small bowel of animals 1 week after injection.Results A diluted concentration (*0.1 mg/ml) of ICG was optimal for NIR imaging compared with the conventional concentration (5 mg/ml) for visual inspection. When injected into the stomach, the signals of ICG and ICG/PGA complex were relatively large at the injection site, and signals were detected at multiple sentinel nodes and lymph nodes beyond them. The NIR-PNG signal intensity was relatively small at the injection site and limited to only one sentinel node with no additional node. When evaluated 1 week after injection, only the NIR-PNG signal was detected in the canine stomach, and the signal intensity at the lymph nodes of the porcine small bowel was the highest with NIR-PNG, followed by ICG/PGA complex and finally ICG. Conclusion NIR-PNG showed the best characteristics of less dispersion and longer retention in the sentinel nodes, and ICG/PGA complex remained longer than diluted ICG. These tracers could potentially be used as optimal tracers for sentinel node navigation surgery in gastric cancer.

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Sentinel Node Mapping Guided by Indocyanine Green Fluorescence Imaging During Laparoscopic Surgery in Gastric Cancer

Cited by 116 publications

References 32 publications

Auxiliary diagnosis of lymph node metastasis in early gastric cancer using quantitative evaluation of sentinel node radioactivity

Auxiliary diagnosis of lymph node metastasis in early gastric cancer using quantitative evaluation of sentinel node radioactivity

Neurotoxic effects of indocyanine green -cerebellar granule cell culture viability study

Evaluation of the novel near-infrared fluorescence tracers pullulan polymer nanogel and indocyanine green/γ-glutamic acid complex for sentinel lymph node navigation surgery in large animal models

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