title: Improvement of the sentinel lymph node detection rate of cervical sentinel lymph node biopsy using real-time fluorescence navigation with indocyanine green in head and neck skin cancer.
abstract: The standard technique using lymphoscintigraphy, blue dye and a gamma probe has established a reliable method for sentinel node biopsy for skin cancer. However, the detection rate of cervical sentinel lymph nodes (SLN) is generally lower than that of inguinal or axillary SLN because of the complexity of lymphatic drainage in the head and neck region and the "shine-through" phenomenon. Recently, indocyanine green fluorescence imaging has been reported as a new method to detect SLN. We hypothesized that fluorescence navigation with indocyanine green in combination with the standard technique would improve the detection rate of cervical sentinel nodes. We performed cervical sentinel node biopsies using the standard technique in 20 basins of 18 patients (group A) and using fluorescence navigation in combination with the standard technique in 12 basins of 16 patients (group B). The mean number of sentinel nodes was two per basin (range, 1-4) in group A and three per basin (range, 1-5) in group B. The detection rate of sentinel nodes was 83% (29/35) in group A and 95% (36/38) in group B. The false-negative rate was 6% (1/18 patients) in group A and 0% in group B. Fluorescence navigation with indocyanine green may improve the cervical sentinel node detection rate. However, greater collection of data regarding the usefulness of cervical sentinel node biopsy using indocyanine green is necessary.
authors.affiliation: Department of Dermatology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. ynakamurta3@yahoo.co.jp
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujisawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maruyama
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Furuta
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kawachi
authors.forename: Fujio
authors.initials: F
authors.lastname: Otsuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D005260:Female; D005453:Fluorescence; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D007208:Indocyanine Green; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009333:Neck; D011183:Postoperative Complications; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green