Detection of sentinel lymph nodes in minimally invasive surgery using indocyanine green and near-infrared fluorescence imaging for uterine and cervical malignancies Journal Article

   

Authors:	Jewell, E. L.; Huang, J. J.; Abu-Rustum, N. R.; Gardner, G. J.; Brown, C. L.; Sonoda, Y.; Barakat, R. R.; Levine, D. A.; Leitao, M. M. Jr
Article Title:	Detection of sentinel lymph nodes in minimally invasive surgery using indocyanine green and near-infrared fluorescence imaging for uterine and cervical malignancies
Abstract:	Objectives Our primary objective was to assess the detection rate of sentinel lymph nodes (SLNs) using indocyanine green (ICG) and near-infrared (NIR) fluorescence imaging for uterine and cervical malignancies. Methods NIR fluorescence imaging for the robotic platform was obtained at our institution in 12/2011. We identified all cases planned for SLN mapping using fluorescence imaging from 12/2011-4/2013. Intracervical ICG was the fluorophobe in all cases. Four cc (1.25 mg/mL) of ICG was injected into the cervix alone divided into the 3- and 9-o'clock positions, with 1 cc deep into the stroma and 1 cc submucosally before initiating laparoscopic entry. Blue dye was concurrently injected in some cases. Results Two hundred twenty-seven cases were performed. Median age was 60 years (range, 28-90 years). Median BMI was 30.2 kg/m 2 (range, 18-60 kg/m2). The median SLN count was 3 (range, 1-23). An SLN was identified in 216 cases (95%), with bilateral pelvic mapping in 179 (79%). An aortic SLN was identified in 21 (10%) of the 216 mapped cases. When ICG alone was used to map cases, 188/197 patients mapped, for a 95% detection rate compared to 93% (28/30) in cases in which both dyes were used (P = NS). Bilateral mapping was seen in 156/197 (79%) ICG-only cases and 23/30 (77%) ICG and blue dye cases (P = NS). Conclusions NIR fluorescence imaging with intracervical ICG injection using the robotic platform has a high bilateral SLN detection rate and appears favorable to using blue dye alone and/or other modalities. Combined use of ICG and blue dye appears unnecessary. © 2014 Elsevier Inc.
Keywords:	sentinel lymph node mapping; sentinel lymph node; uterine cancer; cervical cancer; indocyanine green; near-infrared fluorescence imaging
Journal Title:	Gynecologic Oncology
Volume:	133
Issue:	2
ISSN:	0090-8258
Publisher:	Elsevier Inc.
Date Published:	2014-05-01
Start Page:	274
End Page:	277
Language:	English
DOI:	10.1016/j.ygyno.2014.02.028
PROVIDER:	scopus
PUBMED:	24582865
PMCID:	PMC5715808
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84899618264&partnerID=40&md5=2086ec37c30def6b2b3390985dab171a
Notes:	Gynecol. Oncol. -- Export Date: 2 June 2014 -- CODEN: GYNOA -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/51777