OBJECTIVE: Comparison of systems to detect sentinel lymph node in endometrial carcinoma using indocyanine green. Robotic Firefly Da Vinci fluorescence imaging system (Intuitive Surgical Inc., Sunnyvale, CA, USA) vs. laparoscopic Novadaq Pinpoint near-infrared imaging system (Novadaq, Ontario, Canada). MATERIAL AND METHOD: Fifteen patients with stage I endometrial cancer underwent sentinel lymph node biopsy after intracervical application of indocyanine green. For all of them, the detection was performed sequentially using both evaluated devices. The detection rate, identification match and extent of imaging of the lymphatic system were evaluated. RESULTS: The detection rate of both systems verified on a set of patients was identical, the detected sentinel nodes were identical, and the lymphatic system was shown to the same extent. The quality of the display and overall user-friendliness is different due to the applied technologies. CONCLUSION: Both systems used in minimally invasive surgery provide excelent perioperative imaging of the lymphatic system.
- Klíčová slova
- Da Vinci Firefly, Novadaq Pinpoint, endometrial cancer, indocyanine green, sentinel lymph node,
- MeSH
- biopsie sentinelové lymfatické uzliny metody MeSH
- indokyanová zeleň MeSH
- laparoskopie * metody MeSH
- lidé MeSH
- lymfadenektomie metody MeSH
- lymfatické uzliny patologie MeSH
- nádory endometria * chirurgie patologie MeSH
- roboticky asistované výkony * metody MeSH
- sentinelová uzlina * diagnostické zobrazování patologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- indokyanová zeleň MeSH
In oncological surgery the importance of the sentinel node concept is increasing, as we are capable of reducing the surgical burden of patients and its associated morbidity and preserving adequate oncological safety at the same time. Recently, there has been development of lymph node mapping techniques, where the most promising method appears to be the immunofluorescent one using indocyanine green dye. This technique provides high sensitivity in sentinel node detection in comparison with other existing methods using a dye in combination with a radionuclide. The indocyanine green technique has several advantages, and at the same time, we can use this method in non-oncological indications in gynecological surgery.
- Klíčová slova
- indocyanine green, oncogynecology, sentinel lymphatic node,
- MeSH
- barvicí látky MeSH
- biopsie sentinelové lymfatické uzliny metody MeSH
- indokyanová zeleň * MeSH
- lidé MeSH
- lymfatické metastázy patologie MeSH
- lymfatické uzliny patologie MeSH
- sentinelová uzlina * diagnostické zobrazování patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- barvicí látky MeSH
- indokyanová zeleň * MeSH
INTRODUCTION: In men with ≥pT1G2 cN0, penile cancer lymph node sampling is recommended with either (1) scintigraphically labelled Dynamic sentinel lymph node biopsy (DSLNB) or (2) modified inguinal lymph node dissection (MILND). Although DSLNB is a minimally invasive technique, the false negative rate can be about 10%, and a further operative procedure is required if positive. Open MILND is a diagnostic and therapeutic option but has a much higher morbidity. A potential compromise is the technique of LND-VEILND (video endoscopic inguinal LND) that can be combined with ICG florescence marking of sentinel lymph node (SLN). We present a pilot study of ICG-VEILND. The aim was to validate the applicability of a combination ICG marking of SLN in VEILND (to increase probability to excise SLN) and determine the optimal timing and dosage of ICG. MATERIALS AND METHODS: 15 patients with VEILND (24 groins) underwent ICG application with fluorescence near-infrared (NIR 803⟶830 nm) detection. ICG is applied subcutaneously adjacent to the penile cancer or residual stump of penis or suprapubic region (in a history of total penectomy: 5 cases). The dose of 1.25 mg (ICG) was applied in one case with invisible SLN, the dose of 2.5 mg in 1 mL in 8 cases, and 5 mg in the remaining 6 patients (10 groins). RESULTS: Failure of marking SLN with ICG occurred in 25.0% of cases (6/24): due to application of 1.25 mg ICG, extensive metastasis to SLN, in 4 cases, the cause was unknown (16.7%, 4/24). In the short follow-up period, no local recurrence was seen in the pN0 ICG group. CONCLUSION: Fluorescence infrared image with ICG dye increases the probability of removal of the SLN during VEILND. The dose of ICG is 2.5 (5) mg diluted in 1 ml and can be applied preoperatively even in the suprapubic region in men with a history of total penectomy, with an unexplainable failure of ICG marking in 16.7%.
- MeSH
- indokyanová zeleň MeSH
- lidé MeSH
- lymfadenektomie metody MeSH
- lymfatické uzliny patologie MeSH
- nádory penisu * diagnostické zobrazování patologie chirurgie MeSH
- pilotní projekty MeSH
- sentinelová uzlina * diagnostické zobrazování chirurgie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- indokyanová zeleň MeSH
- Klíčová slova
- axila, breast cancer, sentinel lymph node, surgery,
- MeSH
- axila MeSH
- biopsie sentinelové lymfatické uzliny MeSH
- lidé MeSH
- lymfadenektomie MeSH
- lymfatické uzliny diagnostické zobrazování MeSH
- nádory prsu * diagnostické zobrazování chirurgie MeSH
- retrospektivní studie MeSH
- sentinelová uzlina * diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Certain studies suggest that using indocyanine green (ICG) could be comparable with using radioisotopes (RI) in detecting sentinel lymph nodes (SLNs) in breast cancer. A number of these studies were performed in Asia. The objective of our pilot study was to evaluate within a European population of breast cancer patients the detection rate of SLNs using ICG and the HyperEye system and the concordance in SLNs detected using this method and the standard method involving RI and a gamma probe. METHODS: Ten female patients with early-stage breast cancer (Czech Republic) indicated for partial mastectomy and SLN biopsy were subjected to standard application of RI. Before surgery, ICG was administered periareolarly in the amount of 1 ml of 0.5% solution. Sentinel lymph nodes were first detected perioperatively exclusively using ICG fluorescence and the HyperEye device (Mizuho, Japan). Only after removal of all SLNs found in this way was the standard hand-held gamma probe used to detect RI, and any potential additional SLNs not found with ICG were then extirpated. RESULTS: In all 10 cases, at least one SLN was successfully detected using ICG. Nevertheless, in five patients, 1-4 additional SLNs were found using the gamma probe. Complete concordance in detecting SLNs therefore occurred in only one half of the cases. Metastases in SLNs were found in a total of two cases. Had we used only ICG for detection, one of these two cases would have been incorrectly evaluated as N0 (ICG false negativity). CONCLUSIONS: The study did not confirm the hypothesis that the use of ICG with the HyperEye system can currently be considered a method fully comparable with using RI and a gamma probe in a population of European patients. Although the detection rate is high, a significantly lower number of SLNs were detected using ICG than using RI (p = 0.03). Thus, there would be a higher probability for false negatives to occur in using SLN biopsy. This is caused mainly by the limited permeability of tissues to fluorescent radiation and the difficulty therefore of detecting nodes located deeper beneath the body's surface.
- Klíčová slova
- Breast cancer, Fluorescence, HyperEye, Indocyanine green, Sentinel lymph node biopsy,
- MeSH
- biopsie sentinelové lymfatické uzliny metody MeSH
- fluorescence MeSH
- fluorescenční barviva aplikace a dávkování MeSH
- indokyanová zeleň aplikace a dávkování MeSH
- injekce intradermální MeSH
- lidé MeSH
- lymfatické metastázy MeSH
- mastektomie MeSH
- nádory prsu diagnostické zobrazování patologie chirurgie MeSH
- pilotní projekty MeSH
- radioaktivní indikátory MeSH
- sentinelová uzlina diagnostické zobrazování MeSH
- staging nádorů MeSH
- technecium 99mTc-agregovaný albumin aplikace a dávkování MeSH
- ultrasonografie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- fluorescenční barviva MeSH
- indokyanová zeleň MeSH
- radioaktivní indikátory MeSH
- technecium 99mTc-agregovaný albumin MeSH
- technetium Tc 99m nanocolloid MeSH Prohlížeč
