Role of Indocyanine Green in Sentinel Node Mapping in Gynecologic Cancer: Is Fluorescence Imaging the New Standard?

Sentinel Node and Ovarian Tumors: A Series of 20 Patients

“…The results in endometrial and cervical cancer have certainly been promising. 8,9 Only 1 patient in our series (patient 15) had lymph node metastases, in PC and the right pelvic area. Two SNs were found in the lower PC area, one of which was metastatic and predicted correctly the surgical stage of the patient.…”

Ex vivo indocyanine green fluorescence imaging for the detection of lymph node involvement in advanced‐stage ovarian cancer

“…Near‐infrared fluorescence imaging (NIR‐FI)‐guided surgery using indocyanine green (ICG), a non‐specific fluorophore, has been used as a new tool for sentinel lymph node (SLN) detection in various gynecological (breast, endometrium, cervix, ovary), digestive (colon, stomach), skin, and lung cancers . More recently, it has been reported that ex vivo ICG‐FI is able to detect metastatic LNs of colorectal and head and neck cancer origin .…”

“…[3][4][5]11,12 Near-infrared fluorescence imaging (NIR-FI)-guided surgery using indocyanine green (ICG), a non-specific fluorophore, has been used as a new tool for sentinel lymph node (SLN) detection in various gynecological (breast, endometrium, cervix, ovary), digestive (colon, stomach), skin, and lung cancers. [13][14][15][16][17][18] More recently, it has been reported that ex vivo ICG-FI is able to detect metastatic LNs of colorectal and head and neck cancer origin. 19,20 Using ex vivo ICG-FI, malignant LNs are more fluorescent than benign LNs, suggesting that ICG-FI could represent a potential new imaging technique for the detection of metastatic LNs.…”

Technique of ICG-guided Targeted Compartmental Pelvic Lymphadenectomy (TCL) combined with Pelvic Peritoneal Mesometrial Resection (PMMR) for locoregional control of endometrial cancer – A proposal

“…There is first evidence, that this may hold true also for endometrial cancer in intermediate/high risk endometrial cancer (Kimmig et al, 2015). However, the systematic lymphadenectomy increases morbidity; as a consequence diagnostic sentinel node biopsy was investigated; there is evidence that the accuracy of detection of positive nodes is excellent with a very low false negative rate also with respect to paraaortic disease (Zahl Eriksson et al, 2016, Darin et al, 2016, Sinno et al, 2016, Tschernichovsky et al, 2016, Ruscito et al, 2016). Thus, performing a resection of the tumour bearing compartment “ en bloc ” together with the lymphatic network including the sentinel nodes, it may be suggested that this surgery may be able to control for locoregional recurrence in the pelvis up to the pelvic nodes resected (therapeutically) comparable to (Kimmig et al, 2015) and indicates further need of treatment downstream to these nodes in node positive disease (diagnostically).…”