title: Fluorescent Versus Radioguided Lymph Node Mapping in Bladder Cancer.
abstract: The aim of the study was to compare 2 methods of the sentinel lymph node biopsy (SLNB) procedure in bladder cancer: we applied technetium radiocolloid (RadCol) detected by a gamma ray detection probe, and indocyanine green (ICG) detected by a near-infrared fluorescent (NIRF) camera.
  
  
  
  The SLNB was performed on 50 patients using the RadCol and the ICG, followed by a lymphadenectomy and a pathologic examination.
  
  
  
  In the analyzed group of 47 patients (3 patients were excluded owing to the lack of lymphatic drainage from the tumor), the SLNB was performed using the 2 methods. The ICG with a NIRF-guided camera detected all sentinel lymph nodes (SLNs) in 46 cases, whereas RadCol detected them in 45 cases. In 12 (25.6%) of 47 patients, the ICG-fluorescent method revealed more SLNs than the RadCol method. In 8 (17%) patients, the SLNs revealed in the ICG fluorescence were metastatic. In 3 (6.4%) patients, we found SLNs outside the standard lymphadenectomy template, but a histopathologic examination showed they were negative for cancer. In 3 (6.4%) patients, the SLNs detected by both methods were negative for cancer, but other resected lymph nodes revealed metastases.
  
  
  
  Our study shows that SLNB procedure with the RadCol or the ICG method is useful for the evaluation of lymph nodes in bladder cancer. The new ICG fluorescent technique with a NIRF camera system is safe, enables live view of the results of the procedure, and does not create additional costs. However, it highlights more lymph nodes than the radioactive method.
authors.affiliation: Urology Department, Medical University of Gdańsk, Gdańsk, Poland. Electronic address: wojtek.polom@gmail.com.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Polom
authors.affiliation: Urology Department, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Markuszewski
authors.affiliation: Nuclear Medicine Department, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Cytawa
authors.affiliation: Pathomorphology Department, Medical University of Gdańsk, Gdańsk, Poland; Pathology Department, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
authors.forename: Piotr
authors.initials: P
authors.lastname: Czapiewski
authors.affiliation: Nuclear Medicine Department, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Lass
authors.affiliation: Urology Department, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Matuszewski
mesh_terms: D000368:Aged; D005260:Female; D005456:Fluorescent Dyes / Q000378:metabolism*; D006801:Humans; D007208:Indocyanine Green / Q000378:metabolism; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals / Q000378:metabolism*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D017556:Technetium Compounds / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery
chemical_list: D005456:Fluorescent Dyes; D019275:Radiopharmaceuticals; D017556:Technetium Compounds; D007208:Indocyanine Green
keywords: Bladder cancer; Indocyanine green; Lymphadenectomy; Near-infrared fluorescence; Sentinel lymph node biopsy