title: Double sentinel lymph node mapping with indocyanine green and 99m-technetium-tin colloid in oral squamous cell carcinoma.
abstract: Oral squamous cell carcinoma (OSCC) frequently metastasizes to cervical lymph nodes, which is the most known prognostic factor. Screening methods to identify sentinel lymph nodes (SLNs) are therefore of great interest for the management of potential neck metastasis. The purpose of this study was to evaluate the clinical benefit of double SLN mapping with indocyanine green (ICG) and 99m-technetium-tin colloid ((99m)Tc-tin colloid) for sentinel node navigation surgery (SNNS). Between 2007 and 2010, 16 patients diagnosed with OSCC were investigated by SLN biopsy using the double mapping method. (99m)Tc-tin colloid was injected into the peri-tumoural region on the preoperative day, and ICG was administered intraoperatively in the same position to assist in detecting nodes during surgery. Based on the gamma-ray signal and near-infrared (NIR) fluorescence of ICG, SLNs were identified and thereafter assessed pathologically and genetically for cancer involvement. Radio-guided detection was successful for all patients. ICG mapping identified a relatively larger number of nodes, suggesting that several non-SLNs were potentially involved. The double mapping method assisted surgeons to explore SLNs. Since the ICG fluorescence was shielded by the subcutaneous fatty tissue and the muscle layer including platysma and sternocleidomastoid, it was necessary to retract the tissue away from nodes.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan. Electronic address: ryuichi@m.ehime-u.ac.jp.
authors.forename: R
authors.initials: R
authors.lastname: Murase
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hamakawa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Goda
authors.affiliation: Department of Oral Surgery, Chugoku Central Hospital, Hiroshima, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tano
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ishikawa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Hino
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kyushu Graduate University School of Medicine, Fukuoka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sumida
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Nakashiro
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime Graduate University School of Medicine, Ehime, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Hamakawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004396:Coloring Agents; D005260:Female; D005453:Fluorescence; D006801:Humans; D007208:Indocyanine Green; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D015996:Survival Rate; D017556:Technetium Compounds; D017971:Tin Compounds
chemical_list: D004396:Coloring Agents; D017556:Technetium Compounds; D017971:Tin Compounds; C033493:technetium Tc 99m tin colloid; D007208:Indocyanine Green
keywords: indocyanine green; oral squamous cell carcinoma; sentinel lymph node biopsy