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

Overview

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 (1.25mg/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/m(2)). 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.

publication date

  • February 28, 2014

Research

keywords

  • Adenocarcinoma
  • Carcinosarcoma
  • Coloring Agents
  • Indocyanine Green
  • Leiomyosarcoma
  • Lymph Nodes
  • Sentinel Lymph Node Biopsy
  • Uterine Neoplasms

Identity

PubMed Central ID

  • PMC5715808

Scopus Document Identifier

  • 84899618264

Digital Object Identifier (DOI)

  • 10.1016/j.ygyno.2014.02.028

PubMed ID

  • 24582865

Additional Document Info

volume

  • 133

issue

  • 2