Long-term follow-up results of fluorescence and blue dye guided sentinel lymph node biopsy in early breast cancer

Wang, Chaobin; Tong, Fuzhong; Cao, Yimei; Liu, Peng; Zhou, Bo; Liu, Hongjun; Cheng, Lin; Liu, Miao; Guo, Jiajia; Xie, Fang; Yang, Houpu; Wang, Siyuan; Yuan, Peng; Wang, Shu

doi:10.1007/s10549-021-06196-6

Cited by 20 publications

(14 citation statements)

References 41 publications

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“…They received combined ICG-blue dye technique and SN localization was successful with ICG in all patients in this subgroup. This is in accordance with recent studies that show promising results of this tracer combination after neoadjuvant chemotherapy with an identification rate ranging from 83% to 100% (20)(21)(22) and very low false-negative rates (22).…”

Section: Discussionsupporting

confidence: 93%

“…No recurrence occurred in our study, but the median follow-up was relatively short (30 months). A recent long-term follow-up study by Wang et al (22) confirmed that the ICG-BD combination was safe. In 687 early breast cancer patients who underwent the procedure with histologically negative SN, 0.64% recurred after a median follow-up of 5.6 years.…”

Section: Discussionmentioning

confidence: 90%

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Indocyanine Green Fluorescence-Guided Sentinel Node Biopsy in Breast Cancer Within a North African Population: A Retrospective Study

Hidar¹,

Alimi²,

Khlifi³

et al. 2021

EJBH

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Objective: Radio isotopes and blue dyes alone or in combination are the most commonly used tracer agents in sentinel node (SN) biopsy for early breast cancer. Recent studies have found fluorescence method using indocyanine green (ICG) as a promising technology with fewer disadvantages. Materials and Methods:Retrospective analysis of our database that included patients with clinically node-negative breast cancer scheduled for breast surgery and SN biopsy between 2016 and January 2021. Patients who underwent detection using fluorescence-ICG were included in this study.Results: A total of 47 patients were included. Median age was 50 (range: 24-78) years. Mean tumor size was 3.4 ± 1.5 cm. All patients received ICG injection and 11 received a combination of ICG and blue dye. Forty-five successful SN identifications with ICG were performed and 99 nodes retrieved. Eleven procedures were undertaken after initial systemic therapy. Twenty-four patients had at least one positive SN for malignancy. Mean follow up was 29.2 months and no axillary recurrence was noted during the study period. Conclusion:ICG appears to be a feasible and accurate method for SN biopsy with high identification rate. This is the first study of ICG in sentinel node biopsy in a North African population.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 90%

Indocyanine Green Fluorescence-Guided Sentinel Node Biopsy in Breast Cancer Within a North African Population: A Retrospective Study

Hidar¹,

Alimi²,

Khlifi³

et al. 2021

EJBH

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“…ICG (25 mg per vial) was purchased from Dandong Yichuang Pharmaceutical Co. Ltd., China. ICG has been approved for clinical use for more than 60 years, with good safety and fluorescence performance (peak absorption/emission, 800/830 nm) [ 18 ]. Each vial of ICG was dissolved in its own 10 ml injectable water as the stock solution.…”

Section: Methodsmentioning

confidence: 99%

Intraoperative near-infrared fluorescence imaging can identify pelvic nerves in patients with cervical cancer in real time during radical hysterectomy

Zhang

et al. 2022

Eur J Nucl Med Mol Imaging

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Purpose Radical hysterectomy combined with pelvic lymphadenectomy is the standard treatment for early-stage cervical cancer, but unrecognized pelvic nerves are vulnerable to irreversible damage during surgery. This early clinical trial investigated the feasibility and safety of intraoperative near-infrared (NIR) fluorescence imaging (NIR-FI) with indocyanine green (ICG) for identifying pelvic nerves during radical hysterectomy for cervical cancer. Methods Sixty-six adults with cervical cancer were enrolled in this prospective, open-label, single-arm, single-center clinical trial. NIR-FI was performed in vivo to identify genitofemoral (GN), obturator (ON), and hypogastric (HN) nerves intraoperatively. The primary endpoint was the presence of fluorescence in pelvic nerves. Secondary endpoints were the ICG distribution in a nerve specimen and potential underlying causes of fluorescence emission in pelvic nerves. Results In total, 63 patients were analyzed. The ON was visualized bilaterally in 100% (63/63) of patients, with a mean fluorescence signal-to-background ratio (SBR) of 5.3±2.1. The GN was identified bilaterally in 93.7% (59/63) of patients and unilaterally in the remaining 4 patients, with a mean SBR of 4.1±1.9. The HN was identified bilaterally in 81.0% (51/63) of patients and unilaterally in 7.9% (5/63) of patients, with a mean SBR of 3.5±1.3. ICG fluorescence was detected in frozen sections of a nerve specimen, and was mainly distributed in axons. No ICG-related complications were observed. Conclusion This early clinical trial demonstrated the feasibility and safety of NIR-FI to visualize pelvic nerves intraoperatively. Thus, NIR-FI may help surgeons adjust surgical decision-making, avoid nerve damage, and improve surgical outcomes. Trial registration ClinicalTrials.gov NCT04224467

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“…Indocyanine green (ICG), as a cyanine fluorescent molecule, emits near-infrared wavelengths of fluorescence after excitation by light of a specific wavelength, which can be detected by near-infrared imaging equipment. ICG has been preliminarily used for the localization of SLN in breast, uterine, and gastric cancers, etc., and has shown important advantages and potential (13)(14)(15). Our research is aimed at patients with acral melanoma.…”

Section: Introductionmentioning

confidence: 99%

Application of an indocyanine green surgical fluorescence imaging system in sentinel lymph node biopsy of acral malignant melanoma

et al. 2021

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Background: Regional lymph node status is an independent influencing factor for the prognosis of acral malignant melanoma, and the accuracy of sentinel lymph node biopsy (SLNB) is directly related to the judgment of regional lymph node status. This study aimed to explore the application value of indocyanine green (ICG) surgical fluorescence imaging system in the SLNB of acral malignant melanoma.Methods: A total of 34 patients with acral malignant melanoma were admitted to the Department of Burn and Plastic Surgery in Jiangsu Provincial People's Hospital from January 2020 to March 2020. Among these patients, 22 required SLNB. ICG and methylene blue (MB) were combined to intraoperatively trace the sentinel lymph nodes (SLNs). The total number of SLNs detected during the operation was counted. We compared the number, detection rate, as well as the detection rate and false negative rate of positive SLNs of SLNs detected by ICG, MB, and ICG combined with MB.Results: A total of 56 SLNs were detected in the 22 patients, among which 55 were detected by ICG (98%), 41 were detected by MB (71%), and 56 (100%) were detected by ICG combined with MB, and the average number of SLNs were 2.5, 1.64, and 2.55, respectively. A total of nine SLNs were detected, of which nine were detected by ICG (100%), seven by MB (78%), and nine by ICG combined with MB (100%). Patients with negative SLNs had no recurrence at the 6-month follow-up.Conclusions: Compared with MB, the ICG fluorescent imaging system can improve the detection rate of SLNs in patients with acral malignant melanoma. Also, ICG combined with MB was superior to ICG alone.

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Long-term follow-up results of fluorescence and blue dye guided sentinel lymph node biopsy in early breast cancer

Cited by 20 publications

References 41 publications

Indocyanine Green Fluorescence-Guided Sentinel Node Biopsy in Breast Cancer Within a North African Population: A Retrospective Study

Indocyanine Green Fluorescence-Guided Sentinel Node Biopsy in Breast Cancer Within a North African Population: A Retrospective Study

Intraoperative near-infrared fluorescence imaging can identify pelvic nerves in patients with cervical cancer in real time during radical hysterectomy

Application of an indocyanine green surgical fluorescence imaging system in sentinel lymph node biopsy of acral malignant melanoma

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