Sentinel lymph node biopsy using real-time fluorescence navigation with indocyanine green in cutaneous head and neck/lip mucosa melanomas.
BACKGROUND
The triple technique (lymphoscintigraphy, patent-blue staining, and a gamma probe) constitutes a reliable method for the sentinel lymph node (SLN) biopsy. However, in head and neck melanomas, a shine-through phenomenon, which occurs because these SLNs are close to the primary focus, is irreversibly problematic. To get around the shine-through phenomenon, this study uses the fluorescence navigation with indocyanine green (ICG) as well as the triple technique.


METHODS
ICG is a green dye and can be used as a marker with infrared fluorescence. ICG solution is intradermally injected around the tumor. By using Photodynamic Eye (PDE) intraoperatively, it is possible to observe the injected ICG as SLNs in the fluorescence images.


RESULTS
By use of the fluorescence imaging with ICG, clear identification of the SLN of the case became possible.


CONCLUSIONS
We think the fluorescence navigation with ICG will be a useful option for the SLN biopsy in head and neck melanomas.
Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Sapporo, Japan. toshi-116@nifty.com
Toshihiko
T
Hayashi
Hiroshi
H
Furukawa
Akihiko
A
Oyama
Emi
E
Funayama
Akira
A
Saito
Takeshi
T
Yamao
Yuhei
Y
Yamamoto
D004396:Coloring Agents; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D008048:Lip Neoplasms / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology*; D019265:Spectroscopy, Near-Infrared
D004396:Coloring Agents; D007208:Indocyanine Green