Video-assisted thoracoscopic indocyanine green fluorescence imaging system shows sentinel lymph nodes in non-small-cell lung cancer.
OBJECTIVE
The primary objective was to assess the feasibility and accuracy of intraoperative sentinel lymph node mapping by using a video-assisted thoracoscopic indocyanine green fluorescence imaging system in patients with clinical stage I non-small-cell lung cancer.


METHODS
Thirty-one patients who underwent operation between January 2009 and September 2009 were investigated for sentinel node biopsy. Indocyanine green fluorescence imaging was applied by an infrared light charge-coupled device, and sentinel nodes were identified intraoperatively and dissected. Histologic examination by hematoxylin-eosin staining was used to evaluate metastases.


RESULTS
Sentinel lymph nodes were identified by segmentectomy in 11 of 14 patients (78.5%) and by lobectomy in 14 of 17 patients (82.4%). The total identification rate was 80.7% (25/31 patients), the false-negative rate was 0% (0/24 patients), and the overall accuracy rate was 80.7% (25/31 patients).


CONCLUSIONS
Video-assisted thoracoscopic indocyanine green fluorescence image-guided surgery is feasible for sentinel node biopsy and may be a powerful tool to eliminate unnecessary lymph node dissection in patients with lung cancer.
Yamashita
Shin-ichi
S
Department of Surgery II, Faculty of Medicine, Oita University, Yufu, Oita, Japan. yamashi1@med.oita-u.ac.jp
Tokuishi
Keita
K
Anami
Kentaro
K
Miyawaki
Michiyo
M
Moroga
Toshihiko
T
Kamei
Mirei
M
Suehiro
Shuji
S
Ono
Kiyoshi
K
Takeno
Shinsuke
S
Chujo
Masao
M
Yamamoto
Satoshi
S
Kawahara
Katsunobu
K
D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology* / Q000601:surgery*; D005188:False Negative Reactions; D005240:Feasibility Studies; D005260:Female; D005453:Fluorescence; D005456:Fluorescent Dyes; D006801:Humans; D007208:Indocyanine Green; D007564:Japan; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D020775:Thoracic Surgery, Video-Assisted
D005456:Fluorescent Dyes; D007208:Indocyanine Green