Indocyanine green fluorescence imaging system for sentinel lymph node biopsies in early breast cancer patients.
OBJECTIVE
This study presents a new method that enables the detection of sentinel lymph nodes (SLN) with high sensitivity using indocyanine green (ICG) fluorescence imaging.


METHODS
This study enrolled 128 patients with clinically node-negative breast cancer. Fluorescence imaging was obtained after ICG was injected into the areola. Subcutaneous lymphatic channels were immediately visible.


RESULTS
Lymphatic channels and SLN were successfully visualized in all patients. One lymphatic channel was 60%, two channels were 24%, and three channels were 16%. The number of fluorescence SLN ranged from 1 to 6, and blue-dyed SLN ranged from 0 to 3. In the latter, SLN were not identified in 44 patients. Nineteen patients had pathologically identified lymph node metastases. All of them were recognized by fluorescence imaging, but 8 patients had lymph nodes with metastases were not identified by dye method.


CONCLUSIONS
This ICG fluorescence imaging technique is feasible and safe for detecting SLN in a less invasive manner than conventional mapping, with real-time observations.
Division of General Surgery, Department of Surgery, Shiga University of Medical Science, Seta-Tsukinowa, Otsu, Shiga, Japan.
Hajime
H
Abe
Tsuyoshi
T
Mori
Tomoko
T
Umeda
Makiko
M
Tanaka
Yuki
Y
Kawai
Tomoharu
T
Shimizu
Hirotomi
H
Cho
Yoshihiro
Y
Kubota
Yoshimasa
Y
Kurumi
Tohru
T
Tani
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D005453:Fluorescence; D006801:Humans; D007208:Indocyanine Green; D008875:Middle Aged; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D007208:Indocyanine Green
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