Identification of Metastatic Lymph Nodes Using Indocyanine Green Fluorescence Imaging

Kim, Kyungsu; Han, Kook Nam; Choi, Byoung Ho; Rho, Jiyun; Lee, Jun Hee; Eo, Jae Seon; Kim, Chungyeul; Kim, Beop-Min; Jeong, Sang-Goo; Kim, Hyun Koo

doi:10.3390/cancers15071964

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…ICG, as a nontargeted contrast agent, may be more suitable for detecting pelvic negative LNs rather than metastatic LNs. However, in another study ( 43 ), the intravenous injection of ICG successfully visualized metastatic LNs in mice and tumor patients with an accuracy rate of 83.3%. This finding holds promise as a new method for identifying LN metastasis.…”

Section: Discussionmentioning

confidence: 98%

A preliminary investigation of precise visualization, localization, and resection of pelvic lymph nodes in bladder cancer by using indocyanine green fluorescence-guided approach through intracutaneous dye injection into the lower limbs and perineum

Zhang,

Guo,

Zhang

et al. 2024

Front. Oncol.

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ObjectiveThis study aimed to investigate the feasibility and effectiveness of using indocyanine green (ICG) injected intracutaneously through the lower limbs and perineum for visualized tracking, localization, and qualitative assessment of pelvic lymph nodes (LNs) in bladder cancer to achieve their accurate resection.MethodsFirst, ICG was injected into the LN metastasis model mice lower limbs, and real-time and dynamic in vivo and ex vivo imaging was conducted by using a near-infrared fluorescence imaging system. Additionally, 26 patients with bladder cancer were enrolled and divided into intracutaneous group and transurethral group. A near-infrared fluorescence imaging device with internal and external imaging probes was used to perform real-time tracking, localization, and resection of the pelvic LNs.ResultsThe mice normal LNs and the metastatic LNs exhibited fluorescence. The metastatic LNs showed a significantly higher signal-to-background ratio than the normal LNs (3.9 ± 0.2 vs. 2.0 ± 0.1, p < 0.05). In the intracutaneous group, the accuracy rate of fluorescent-labeled LNs was 97.6%, with an average of 11.3 ± 2.4 LNs resected per patient. Six positive LNs were detected in three patients (18.8%). In the transurethral group, the accuracy rate of fluorescent-labeled LNs was 84.4%, with an average of 8.6 ± 2.3 LNs resected per patient. Two positive LNs were detected in one patient (12.5%).ConclusionFollowing the intracutaneous injection of ICG into the lower limbs and perineum, the dye accumulates in pelvic LNs through lymphatic reflux. By using near-infrared fluorescence laparoscopic fusion imaging, physicians can perform real-time tracking, localization, and precise resection of pelvic LNs.

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Section: Discussionmentioning

confidence: 98%

A preliminary investigation of precise visualization, localization, and resection of pelvic lymph nodes in bladder cancer by using indocyanine green fluorescence-guided approach through intracutaneous dye injection into the lower limbs and perineum

Zhang,

Guo,

Zhang

et al. 2024

Front. Oncol.

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A Tumor‐Activatable Liposomal Nanoprobe for Selective Visualization of Metastatic Lymph Nodes

Cui,

Xia,

Liu

et al. 2024

Adv Healthcare Materials

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The precise identification of sentinel lymph nodes (SLNs) during surgery and assessment of their benign status is crucial for accurate tumor staging and optimal treatment strategizing. Currently, a deficiency exists in non‐invasive in vivo diagnostic techniques that can accurately pinpoint SLNs during surgery while simultaneously evaluating their benign status. Here, a tumor‐activatable liposomal nanoprobe (nTAL) is developed, remotely loaded with clinically approved photosensitizer, methyl aminolevulinate (MAL), to noninvasively visualize the tumor metastasis lymph nodes (LNs) with precision. Benefited from the highly efficient LNs draining of nanosized liposome and tumor cell‐specific transformation of the non‐fluorescent MAL to fluorescent protoporphyrin IX (PPIX), nTAL succeeded in targeting the SLNs and differentiated the metastatic from the benign ones with a positive correlation between PPIX generation and tumor cell infiltration in LNs. Moreover, the nTAL technology is capable of probing the early metastatic stage with a primary tumor size of 50 mm3. This study provides a new strategy for intraoperative visualization of real‐time sentinel node dissection.

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Comparison of Postoperative Outcomes Between Near-Infrared Fluorescent Imaging-Guided Mediastinal Lymphadenectomy and Conventional Surgery for Esophageal Cancer

Ao,

Zhong,

Luo

et al. 2024

Ann Surg Oncol

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Identification of Metastatic Lymph Nodes Using Indocyanine Green Fluorescence Imaging

Cited by 3 publications

References 42 publications

A preliminary investigation of precise visualization, localization, and resection of pelvic lymph nodes in bladder cancer by using indocyanine green fluorescence-guided approach through intracutaneous dye injection into the lower limbs and perineum

A preliminary investigation of precise visualization, localization, and resection of pelvic lymph nodes in bladder cancer by using indocyanine green fluorescence-guided approach through intracutaneous dye injection into the lower limbs and perineum

A Tumor‐Activatable Liposomal Nanoprobe for Selective Visualization of Metastatic Lymph Nodes

Comparison of Postoperative Outcomes Between Near-Infrared Fluorescent Imaging-Guided Mediastinal Lymphadenectomy and Conventional Surgery for Esophageal Cancer

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