title: Indocyanine green-guided sentinel lymph node biopsy for periocular tumors.
abstract: OBJECTIVE
  To compare the accuracy of indocyanine green (ICG)-guided sentinel lymph node biopsy to sentinel lymph node biopsy performed with technetium-99m in eyelid and in conjunctival malignancies.
  
  
  METHODS
  Review of a consecutive series of adult patients undergoing sentinel lymph node biopsy for eyelid and conjunctival malignancies between 2009 and 2013. Only patients undergoing both ICG-guided and technetium-99m-guided sentinel lymph node biopsies were included.
  
  
  RESULTS
  Five patients were identified: 3 women and 2 men. Four had conjunctival melanoma and 1 had eyelid melanoma. ICG aided in localization and confirmation of the sentinel nodes identified by technetium-99m, and all sentinel lymph nodes identified by technetium-99m were identified by ICG. All patients who underwent both sentinel lymph node modalities had negative lymph node biopsies for micrometastasis, but metastatic disease eventually developed in 1 patient. No safety concerns were identified with the use of ICG in the ocular adnexal region.
  
  
  CONCLUSIONS
  For certain periocular malignancies, ICG-guided sentinel lymph node biopsy safely identifies sentinel lymph nodes intraoperatively possibly to a similar extent compared with technetium-99m-guided methods.
authors.affiliation: *Department of Ophthalmology and †Department of Plastic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.
authors.forename: Tal J
authors.initials: TJ
authors.lastname: Rubinstein
authors.forename: Julian D
authors.initials: JD
authors.lastname: Perry
authors.forename: Jason M
authors.initials: JM
authors.lastname: Korn
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Costin
authors.forename: Brian R
authors.initials: BR
authors.lastname: Gastman
authors.forename: Arun D
authors.initials: AD
authors.lastname: Singh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004396:Coloring Agents; D003230:Conjunctival Neoplasms / Q000473:pathology*; D005142:Eyelid Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D007208:Indocyanine Green; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000556:secondary*; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D016284:Technetium Tc 99m Pentetate
chemical_list: D004396:Coloring Agents; D019275:Radiopharmaceuticals; D007208:Indocyanine Green; D016284:Technetium Tc 99m Pentetate