title: Use of indocyanine green for detecting the sentinel lymph node in breast cancer patients: from preclinical evaluation to clinical validation.
abstract: Assessment of the sentinel lymph node (SLN) in patients with early stage breast cancer is vital in selecting the appropriate surgical approach. However, the existing methods, including methylene blue and nuclides, possess low efficiency and effectiveness in mapping SLNs, and to a certain extent exert side effects during application. Indocyanine green (ICG), as a fluorescent dye, has been proved reliable usage in SLN detection by several other groups. In this paper, we introduce a novel surgical navigation system to detect SLN with ICG. This system contains two charge-coupled devices (CCD) to simultaneously capture real-time color and fluorescent video images through two different bands. During surgery, surgeons only need to follow the fluorescence display. In addition, the system saves data automatically during surgery enabling surgeons to find the registration point easily according to image recognition algorithms. To test our system, 5 mice and 10 rabbits were used for the preclinical setting and 22 breast cancer patients were utilized for the clinical evaluation in our experiments. The detection rate was 100% and an average of 2.7 SLNs was found in 22 patients. Our results show that the usage of our surgical navigation system with ICG to detect SLNs in breast cancer patients is technically feasible.
authors.affiliation: Intelligent Medical Research Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
authors.forename: Chongwei
authors.initials: C
authors.lastname: Chi
authors.affiliation: Intelligent Medical Research Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
authors.forename: Jinzuo
authors.initials: J
authors.lastname: Ye
authors.affiliation: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China.
authors.forename: Haolong
authors.initials: H
authors.lastname: Ding
authors.affiliation: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China.
authors.forename: De
authors.initials: D
authors.lastname: He
authors.affiliation: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China.
authors.forename: Wenhe
authors.initials: W
authors.lastname: Huang
authors.affiliation: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China.
authors.forename: Guo-Jun
authors.initials: GJ
authors.lastname: Zhang
authors.affiliation: Intelligent Medical Research Center, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Tian
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D004195:Disease Models, Animal; D005260:Female; D005456:Fluorescent Dyes / Q000008:administration & dosage / Q000493:pharmacokinetics; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage / Q000493:pharmacokinetics; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D051379:Mice; D008875:Middle Aged; D009367:Neoplasm Staging; D011817:Rabbits; D021701:Sentinel Lymph Node Biopsy
chemical_list: D005456:Fluorescent Dyes; D007208:Indocyanine Green