title: Impact of Indocyanine Green for Sentinel Lymph Node Mapping in Early Stage Endometrial and Cervical Cancer: Comparison with Conventional Radiotracer (99m)Tc and/or Blue Dye.
abstract: To compare the detection rate (DR) and bilateral optimal mapping (OM) of sentinel lymph nodes (SLNs) in women with endometrial and cervical cancer using indocyanine green (ICG) versus the standard technetium-99m radiocolloid ((99m)Tc) radiotracer plus methylene or isosulfan blue, or blue dye alone.
  
  
  
  From October 2010 to May 2015, 163 women with stage I endometrial or cervical cancer (118 endometrial and 45 cervical cancer) underwent SLN mapping with (99m)Tc with blue dye, blue dye alone, or ICG. DR and bilateral OM of ICG were compared respectively with the results obtained using the standard (99m)Tc radiotracer with blue dye, or blue dye alone.
  
  
  
  SLN mapping with (99m)Tc radiotracer with blue dye was performed on 77 of 163 women, 38 with blue dye only and 48 with ICG. The overall DR of SLN mapping was 97, 89, and 100 % for (99m)Tc with blue dye, blue dye alone, and ICG, respectively. The bilateral OM rate for ICG was 85 %-significantly higher than the 58 % obtained with (99m)Tc with blue dye (p = 0.003) and the 54 % for blue dye (p = 0.001). Thirty-one women (19 %) had positive SLNs. Sensitivity and negative predictive value of SLN were 100 % for all techniques.
  
  
  
  SLNs mapping using ICG demonstrated higher DR compared to other modalities. In addition, ICG was significantly superior to (99m)Tc with blue dye in terms of bilateral OM in women with early stage endometrial and cervical cancer. The higher number of bilateral OM may consequently reduce the overall number of complete lymphadenectomies, reducing the duration and additional costs of surgical treatment.
authors.affiliation: Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy. ginoncmonza@gmail.com.|University of Milano-Bicocca, Monza, Italy. ginoncmonza@gmail.com.
authors.forename: Alessandro
authors.identifier: 0000-0002-7093-6862
authors.initials: A
authors.lastname: Buda
authors.affiliation: University of Milano-Bicocca, Monza, Italy.|Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Crivellaro
authors.affiliation: Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Elisei
authors.affiliation: Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.|University of Milano-Bicocca, Monza, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Di Martino
authors.affiliation: Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Guerra
authors.affiliation: Department of Medical Physics, San Gerardo Hospital, Monza, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: De Ponti
authors.affiliation: University of Milano-Bicocca, Monza, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cuzzocrea
authors.affiliation: Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.|University of Milano-Bicocca, Monza, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Giuliani
authors.affiliation: Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.|University of Milano-Bicocca, Monza, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Sina
authors.affiliation: Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.|University of Milano-Bicocca, Monza, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Magni
authors.affiliation: University of Milano-Bicocca, Monza, Italy.|Department of Nuclear Medicine, San Gerardo Hospital, Monza, Italy.|Technomed Foundation, University of Milano-Bicocca, Monza, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Landoni
authors.affiliation: Gynecologic Oncology Surgery Unit, Department of Obstetrics and Gynecology, San Gerardo Hospital, Monza, Italy.|University of Milano-Bicocca, Monza, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Milani
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D016889:Endometrial Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007208:Indocyanine Green; D008875:Middle Aged; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy; D013671:Technetium Tc 99m Sulfur Colloid; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
chemical_list: D004396:Coloring Agents; D019275:Radiopharmaceuticals; D012394:Rosaniline Dyes; C025484:iso-sulfan blue; D013671:Technetium Tc 99m Sulfur Colloid; D007208:Indocyanine Green