Blue-dye intraoperative sentinel lymph node mapping in early non-small cell lung cancer

Rzyman, Witold; Hagen, Ole Magnus; Dziadziuszko, Rafał; Kobierska‐Gulida, Grażyna; Karmolinski, Andrzej; Lothe, M.I.; Paleczka, W.; Murawski, Marek; Jastrzébski, T; Kopacz, Andrzej; Jassem, Jacek; Skokowski, Jarosław

doi:10.1016/j.ejso.2006.01.005

Cited by 20 publications

(10 citation statements)

References 18 publications

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“…Blue dyes and radiocolloid tracers have not demonstrated reproducible or accurate SLN detection even in multicenter studies, in large part due to pigmented anthracotic thoracic LNs, high tracer background signal, and rapid migration due to small particle size 36–37 . The one patient in this trial who underwent concurrent methylene blue injection did demonstrate equivalent localization with lesional “tattoo”, however there was no discernible migration to LNs and the SLN was identified only by ICG.…”

Section: Discussionmentioning

confidence: 99%

A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer

Hachey

Digesu

Armstrong

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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Objective To investigate safety and feasibility of navigational bronchoscopy (NB)-guided near-infrared (NIR) localization of small, ill-defined lung lesions and sentinel lymph nodes (SLN) for accurate staging in non-small cell lung cancer (NSCLC) patients. Methods Patients with known or suspected stage I NSCLC were enrolled in a prospective pilot trial for lesion localization and SLN mapping via NB-guided NIR marking. Successful localization, SLN detection rates, histopathologic status of SLN vs overall nodes, and concordance to initial clinical stage were measured. Ex vivo confirmation of NIR+ SLNs and adverse events were recorded. Results Twelve patients underwent NB-guided marking with indocyanine green (ICG) of lung lesions ranging in size from 0.4 to 2.2 cm and located 0.1 to 3 cm from the pleural surface. An NIR+ “tattoo” was identified in all cases. Ten patients were diagnosed with NSCLC and 9 SLNs were identified in 8 of the 10 patients, resulting in an 80% SLN detection rate. SLN pathologic status was 100% sensitive and specific for overall nodal status with no false negative results. Despite prior nodal sampling, one patient was found to have metastatic disease in the SLN alone, a 12.5% rate of disease upstaging with NIR SLN mapping. SLN were detectable for up to 3 hours allowing time for obtaining a tissue diagnosis and surgical resection. There were no adverse events associated with NB-labeling or ICG dye itself. Conclusions NB-guided NIR lesion localization and SLN identification was safe and feasible. This minimally invasive image-guided technique may permit the accurate localization and nodal staging of early stage lung cancers.

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Section: Discussionmentioning

confidence: 99%

A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer

Hachey

Digesu

Armstrong

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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“…Some smaller branches may drain directly to paraaortic nodes and then to the thoracic duct [19], which are not visualized in irresectable tumors. Moreover, some authors indicate that pancreatic drainage may accompany multidirectional venous drainage with the absence of a solitary sentinel lymph node, similarly to lung cancer [20]. …”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node mapping in tumors of the pancreatic body: preliminary report

Durczyński

Hogendorf²,

Szymański³

et al. 2012

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Aim of the studyActual lymphatic drainage of pancreatic body neoplasms and the proper extent of lymphadenectomy remain unknown. The aim of the study was to define the exact lymphatic draining pattern using the dye mapping method.Material and methodsThe study enrolled patients who were operated on for tumor of the pancreatic body in the Department of General and Transplant Surgery of the Medical University of Lodz during 2010, with injection of 1 ml of blue dye (Patent Blue, Guerbet) in the centre of the neoplasm and sentinel node identification. Radical surgical management included distal pancreatectomy, whereas gastrojejunal or triple bypass anastomoses were performed in irresectable cases.ResultsThe study group consisted of 13 patients with locally advanced tumors of the pancreatic body (T3 and T4, mean tumor size 4.9 cm). Lymphatic mapping was able to identify sentinel nodes in 5 of 13 cases (38.46%). A sentinel node was found in station 11p (3 cases) and 9 (1 case). Skip metastasis to the left gastric artery node (group 7) was noted. All identified sentinel nodes were metastatic; tumor deposits were confirmed in non-sentinel nodes as well.ConclusionsIn advanced pancreatic body tumors feasibility of sentinel node navigation is considerably restricted. Further studies in smaller tumors using optimized newer markers may define the exact lymphatic draining pattern.

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“…Sentinel lymph node localization is currently performed by administering radiocolloids conjugated with blue dye for intraoperative guidance [34]. The potential of implementing other organic optical dyes such as fluorescein and indocyanine green has also been demonstrated in multiple clinical trials [2,17,19–21,23].…”

Section: Discussionmentioning

confidence: 99%

Video-rate fluorescence diffuse optical tomography for in vivo sentinel lymph node imaging

Solomon¹,

White²,

Nothdruft³

et al. 2011

Biomed. Opt. Express

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We have developed a fiber-based, video-rate fluorescence diffuse optical tomography (DOT) system for noninvasive in vivo sentinel lymph node (SLN) mapping. Concurrent acquisition of fluorescence and reference signals allowed the efficient generation of ratio-metric data for 3D image reconstruction. Accurate depth localization and high sensitivity to fluorescent targets were established in to depths of >10 mm. In vivo accumulation of indocyanine green (ICG) dye was imaged in the region of the SLN following intradermal injection into the forepaw of rats. These results suggest that video-rate fluorescence DOT has significant potential as a clinical tool for noninvasive mapping of SLN.

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Blue-dye intraoperative sentinel lymph node mapping in early non-small cell lung cancer

Cited by 20 publications

References 18 publications

A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer

A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer

Sentinel lymph node mapping in tumors of the pancreatic body: preliminary report

Video-rate fluorescence diffuse optical tomography for in vivo sentinel lymph node imaging

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