title: Comparison between the indocyanine green fluorescence and blue dye methods for sentinel lymph node biopsy using novel fluorescence image-guided resection equipment in different types of hospitals.
abstract: Sentinel lymph node biopsy (SLNB) has become a standard of care to detect axillary lymph metastasis in early-stage breast cancer patients with clinically negative axillary lymph nodes. Current SLNB detection modalities comprising a blue dye, a radioactive tracer, or a combination of both have advantages as well as disadvantages. Thus, near-infrared fluorescence imaging using indocyanine green (ICG) has recently been regarded as a novel method that has generated interest for SLNB around the world. However, the lack of appropriate fluorescence imaging systems has hindered further research and wide application of this method. Therefore, we developed novel fluorescence image-guided resection equipment (FIRE) to detect sentinel lymph nodes (SLNs). Moreover, to compare the ICG fluorescence imaging method with the blue dye method and to explore the universal feasibility of the former, a different type of hospital study was conducted. Ninety-nine eligible patients participated in the study at 3 different types of hospitals. After subcutaneous ICG allergy testing, all the patients were subcutaneously injected with methylene blue and ICG into the subareolar area. Consequently, 276 SLNs (range 1-7) were identified in 98 subjects (detection rate: 99%) by using the ICG fluorescence imaging method. In contrast, the blue dye method only identified 202 SLNs (range 1-7) in 91 subjects (detection rate: 91.92%). Besides, the results of the fluorescence imaging method were similar in the 3 hospitals. Our findings indicate the universal feasibility of the ICG fluorescence imaging method for SLNB using the fluorescence image-guided resection equipment in early breast cancer detection.
authors: Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
authors: Kunshan
authors: K
authors: He
authors: Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China; Key Laboratory of Molecular Imaging of Beijing, Beijing, China.
authors: Chongwei
authors: C
authors: Chi
authors: Department of General Surgery, General Hospital of People's Liberation Army, Beijing, China.
authors: Deqiang
authors: D
authors: Kou
authors: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China.
authors: Wenhe
authors: W
authors: Huang
authors: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China.
authors: Jundong
authors: J
authors: Wu
authors: Department of Thyroid and Breast Surgery, Yijishan Hospital, Wannna Medical College, Wuhu, China.
authors: Yabing
authors: Y
authors: Wang
authors: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China.
authors: Lifang
authors: L
authors: He
authors: Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
authors: Jinzuo
authors: J
authors: Ye
authors: Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China.
authors: Yamin
authors: Y
authors: Mao
authors: The Breast Center, Cancer Hospital, Shantou University Medical College, Shantou, China. Electronic address: guoj_zhang@yahoo.com.
authors: Guo-Jun
authors: GJ
authors: Zhang
authors: Department of General Surgery, General Hospital of People's Liberation Army, Beijing, China. Electronic address: vicky1968@163.com.
authors: Jiandong
authors: J
authors: Wang
authors: Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Institute of Automation, Chinese Academy of Sciences, Beijing, China; Key Laboratory of Molecular Imaging of Beijing, Beijing, China. Electronic address: tian@ieee.org.
authors: Jie
authors: J
authors: Tian
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005453:Fluorescence; D006761:Hospitals; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D007208:Indocyanine Green / Q000378:metabolism*; D007430:Intraoperative Care; D008751:Methylene Blue / Q000378:metabolism*; D008875:Middle Aged; D000071036:Sentinel Lymph Node / Q000473:pathology* / Q000601:surgery*; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation* / Q000379:methods*
chemical_list: D007208:Indocyanine Green; D008751:Methylene Blue