title: Indocyanine green fluorescence-guided sentinel lymph node biopsy in dermato-oncology.
abstract: BACKGROUND
  Sentinel lymph node biopsy (SLNB) for cutaneous malignancies usually carried out with radioactive nanocolloids (Tc-99m). The SLNE is controversially discussed internationally. This is especially given to the high false-negative rate up to 44 %. An alternative could be the fluorescent dye indocyanine green (ICG).
  
  
  METHODS
  We investigated the advantage of intraoperative fluorescence detection of lymphatic vessels and SLN with a Near-Infrared (NIR) camera in comparison to conventional methods using preoperative lymphoscintigraphy and SPECT/CT in 22 patients with malignant melanoma.
  
  
  RESULTS
  A total of 61 SLNs were removed in 22 operative procedures. In 7 SLN (10.3 %; 7/68) the histopathological assessment could demonstrate a metasta-tic involvement. 11 additional SLN (19.1 %) in 8 patients were only identified using the fluorescent labeling. Two of these additional SLN (9.1 %; 2/22) showed metastatic involvement.
  
  
  CONCLUSIONS
  The ICG fluorescence-guided SLNB is an innovative imaging technique for dermato-oncology, reliable and providing additional information in the detection of SLN. Therefore SLNB with fluorescence-dye is an attractive option with intraoperative real-time lymphoscintigraphy to improve the detection of SLN in cutaneous malignancies and potential reduction of the false negative rate in SLN.
authors: Department of Dermatology, Venereology and Allergology, University of Essen-Duisburg, Germany.
authors: Ingo
authors: I
authors: Stoffels
authors: Hannah
authors: H
authors: von der Stück
authors: Christian
authors: C
authors: Boy
authors: Thorsten
authors: T
authors: Pöppel
authors: Nina
authors: N
authors: Körber
authors: Maren
authors: M
authors: Weindorf
authors: Joachim
authors: J
authors: Dissemond
authors: Dirk
authors: D
authors: Schadendorf
authors: Joachim
authors: J
authors: Klode
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008856:Microscopy, Fluorescence / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology*; D025321:Surgery, Computer-Assisted / Q000379:methods*
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green