Sentinel Node Navigation Surgery Using Indocyanine Green in Patients with Lung Cancer

Ito, Norimasa; Fukuta, Mikihisa; Tokushima, Takeshi; Nakai, Kaoru; Ohgi, Shigetsugu

doi:10.1007/s00595-004-2780-y

Cited by 44 publications

(42 citation statements)

References 8 publications

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“…Recently, there have been clinical imaging studies using the FDA-approved dye indocyanine green (ICG) for detection of sentinel lymph nodes in patients with gastric, 15 intrathoracic, 16,17 and lung cancer. 18 Surgical oncologists are currently investigating mapping regional metastasis by fluorescent optical imaging using ICG, noncovalently bound to human serum albumin. 19 However, the albumin remains nonspecific for cancer.…”

Section: Discussionmentioning

confidence: 99%

“…1 Complete removal of cervical lymph nodes is performed in patients with head and neck cancer for prognostic and therapeutic reasons; however, cervical lymphadectomy is associated with significant morbidity and operative time. Noninvasive imaging modalities used for detecting metastatic disease are CT, MR, and 18 F-fluoro-deoxyglucose positron emission tomography (FDG PET). The most sensitive and specific modality of imaging pulmonary metastasis is currently performed by PET-CT imaging, followed by lung or mediastinal lymph node biopsy.…”

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confidence: 99%

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Fluorescent labeled anti‐EGFR antibody for identification of regional and distant metastasis in a preclinical xenograft model

et al. 2008

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Fluorescent labeled anti‐EGFR antibody for identification of regional and distant metastasis in a preclinical xenograft model

et al. 2008

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“…The radioisotope-guided (RI-guided) approach can accurately determine the location of deep SLNs, but cannot identify minute lymphatic vessels. 5 To identify the SLN and confirm the applicability of the SLN concept to bladder cancer, we need an anatomical understanding of the lymphatic network and flow around the bladder. The primary contributions to the knowledge of bladder lymphatics have come from European sources and were well-summarized by Leadbetter and Cooper.…”

Section: Introductionmentioning

confidence: 99%

Identification of lymphatic pathway involved in the spread of bladder cancer: Evidence obtained from fluorescence navigation with intraoperatively injected indocyanine green

Inoue

Shiina

Mitsui

et al. 2012

CUAJ

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E322Cite as: Can Urol Assoc J 2013;7(5-6):e322-8. http://dx.doi.org/10.5489/cuaj.12096 Published online May 13, 2013 (early released September 10, 2012). AbstractIntroduction: We identify lymphatic vessels draining from the bladder by using fluorescence navigation (FN) system. Methods: In total, 12 candidates for radical cystectomy and pelvic lymph node dissection (PLND) were included in this study. After an indocyanine green (ICG) solution was injected into the bladder during radical cystectomy, lymphatic vessels draining from the bladder were analyzed using a FN system. PLND was based on the lymphatic mapping created from the FN measurements (in vivo probing) in the external iliac, obturator and internal iliac regions; after PLND, the fluorescence of the removed lymph nodes (LNs) was analyzed on the bench (ex vivo probing). Results: There were no patients with complications associated with the intravesical ICG injection. A lymphatic pathway along inferior vesical vessels to internal iliac LNs was clearly illustrated in 7 cases. Under in-vivo probing, the fluorescence intensity of internal iliac nodes was greater than that of external iliac or obturator nodes. Under ex-vivo probing, the fluorescence intensity of internal iliac and obturator nodes was greater than that of external iliac nodes. Conclusions: Using an FN system after injecting ICG during a radical cystectomy operation is a safe and rational approach to detecting the lymphatic channel draining from the bladder. IntroductionThe sentinel lymph node (SLN) is the first lymph node (LN) through which cancer cells are detected from the primary site. The SLN concept is based on the hypothesis that secondary cancer cells are not found in LNs downstream from the first one receiving drainage from the primary tumour. The validity of this concept is well-established in breast and skin cancers, 1,2 and it has also been applied to penile cancer by Cabanas.3 Liedberg and colleagues reported the possibility of applying the SLN concept to bladder cancer using γ probe-guided SLN dissection, 4 but their approach combining preoperative lymphoscintigraphy with an intraoperative γ probe is complicated. Until now, two approaches have been used to identify SLNs: the dye-guided approach and the radioisotope-guided (RI-guided) approach. The dyeguided approach appears to be convenient and safe, but it sometimes cannot precisely detect SLNs deep in the pelvis, because the contrast of the target tissue is insufficient. The radioisotope-guided (RI-guided) approach can accurately determine the location of deep SLNs, but cannot identify minute lymphatic vessels. 5To identify the SLN and confirm the applicability of the SLN concept to bladder cancer, we need an anatomical understanding of the lymphatic network and flow around the bladder. The primary contributions to the knowledge of bladder lymphatics have come from European sources and were well-summarized by Leadbetter and Cooper. 6 Normal vesical lymphatics drain into the perivesical network, from which originate 6 groups of p...

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“…Low-resolution NIR-ICG imaging has been used to identify sentinel LN during tumor resection surgery for a decade [59, 60], but appropriate optics with computer analyses to quantify human lymphatic function was introduced only recently. In these pioneering studies, groups such as that of Sevick-Muraca and colleagues applied NIR-ICG imaging techniques to evaluate lymphatic vessels in patients with lymphedema [61–63].…”

Section: Introductionmentioning

confidence: 99%

Lymphatic imaging to assess rheumatoid flare: mechanistic insights and biomarker potential

et al. 2016

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Proliferation of draining lymphatic vessels coupled with dynamic changes in lymph node volume and flow are characteristic features in rheumatoid arthritis (RA). Furthermore, impaired lymph egress from inflamed synovium is associated with joint flare in murine models of inflammatory-erosive arthritis. Unfortunately, advances towards a greater understanding of lymphatic changes in RA pathogenesis have been slow due to the absence of outcome measures to quantify lymphatic function in vivo. While lymphoscintigraphy is the current standard to assess lymphedema and sentinel lymph nodes in cancer patients, its sensitivity and specificity are inadequate to study lymphatics in RA. The emergence of high-resolution MRI, power Doppler ultrasound, and near-infrared imaging that permits real-time quantification of lymphatic function in animal models has been a major advance, and these techniques have produced a new paradigm of altered lymphatic function that underlies both acute arthritic flare and chronic inflammation. In acute flare, lymphatic drainage increases several fold, whereas no lymphatic contractions are detected in lymph vessels draining chronic arthritic joints. Moreover, these outcomes are now being adapted to study lymphatics in RA towards the development of novel biomarkers of arthritic flare and the discovery of new therapeutic targets. In particular, interventions that directly increase lymphatic egress from diseased joints by opening collateral lymphatic vessels, and that restore lymphatic vessel contractions, provide novel therapeutic approaches with potential for minimal toxicity and immunosuppression. To summarize the origins of this field, recent advances, and future directions, we herein review: current knowledge of lymphatics in RA based on classic literature; new in-vivo imaging modalities that have elucidated how lymphatics modulate acute versus chronic joint inflammation in murine models; and how these preclinical outcome measures are being translated to study lymphatic function in RA inflammation and how effective RA therapies alter lymphatic flow and lymph nodes draining flaring joints. Trial registration: ClinicalTrials.gov NCT02680067. Registered 7 December 2015; ClinicalTrials.gov NCT01098201. Registered 30 March 2010; and ClinicalTrials.gov NCT01083563. Registered 8 March 2010.Electronic supplementary materialThe online version of this article (doi:10.1186/s13075-016-1092-0) contains supplementary material, which is available to authorized users.

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Sentinel Node Navigation Surgery Using Indocyanine Green in Patients with Lung Cancer

Abstract: These findings support the efficiency of SNNS for clinically node-negative lung cancer.

Cited by 44 publications

References 8 publications

Fluorescent labeled anti‐EGFR antibody for identification of regional and distant metastasis in a preclinical xenograft model

Fluorescent labeled anti‐EGFR antibody for identification of regional and distant metastasis in a preclinical xenograft model

Identification of lymphatic pathway involved in the spread of bladder cancer: Evidence obtained from fluorescence navigation with intraoperatively injected indocyanine green

Lymphatic imaging to assess rheumatoid flare: mechanistic insights and biomarker potential

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