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A Comparison of Radiocolloid and Indocyanine Green Fluorescence Imaging, Sentinel Lymph Node Mapping in Patients with Cervical Cancer Undergoing Laparoscopic Surgery.

Imboden S, Papadia A, Nauwerk M, McKinnon B, Kollmann Z, Mohr S, Lanz S, Mueller MD - Ann. Surg. Oncol. (2015)

Bottom Line: Sensitivity, specificity, and overall and bilateral detection rates were calculated and compared.SLNs were ninefold more likely to be affected by metastatic disease compared with NSLNs (p < 0.005).Overall detection rates were 83 and 95.5 % (p = nonsignificant), and bilateral detection rates were 61 and 95.5 % (p < 0.005), for Groups 1 and 2, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland.

ABSTRACT

Background and purpose: (99)TC combined with blue-dye mapping is considered the best sentinel lymph node (SLN) mapping technique in cervical cancer. Indocyanine green (ICG) with near infrared fluorescence imaging has been introduced as a new methodology for SLN mapping. The aim of this study was to compare these two techniques in the laparoscopic treatment of cervical cancer.

Methods: Medical records of patients undergoing laparoscopic SLN mapping for cervical cancer with either (99)Tc and patent blue dye (Group 1) or ICG (Group 2) from April 2008 until August 2012 were reviewed. Sensitivity, specificity, and overall and bilateral detection rates were calculated and compared.

Results: Fifty-eight patients were included in the study-36 patients in Group 1 and 22 patients in Group 2. Median tumor diameter was 25 and 29 mm, and mean SLN count was 2.1 and 3.7, for Groups 1 and 2, respectively. Mean non-SLN (NSLN) count was 39 for both groups. SLNs were ninefold more likely to be affected by metastatic disease compared with NSLNs (p < 0.005). Sensitivity and specificity were both 100 %. Overall detection rates were 83 and 95.5 % (p = nonsignificant), and bilateral detection rates were 61 and 95.5 % (p < 0.005), for Groups 1 and 2, respectively. In 75 % of cases, SLNs were located along the external or internal iliac nodal basins.

Conclusions: ICG SLN mapping in cervical cancer provides high overall and bilateral detection rates that compare favorably with the current standard of care.

No MeSH data available.


Related in: MedlinePlus

a Right pelvic ICG-positive SLN as seen with laparoscopic NIR technology. b ICG-positive SLN as seen with laparoscopic NIR technology. ICG indocyanine green, NIR near infrared, SLN sentinel lymph node
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Fig1: a Right pelvic ICG-positive SLN as seen with laparoscopic NIR technology. b ICG-positive SLN as seen with laparoscopic NIR technology. ICG indocyanine green, NIR near infrared, SLN sentinel lymph node

Mentions: In Group 2, the patient was intracervically injected with 8–10 ml of ICG (Pulsion®) in the OR, immediately before laparoscopy. One vial of ICG (Pulsion®) had been previously suspended with 20 ml of sterile water. Under visual guidance of the fluorescent light using a laparoscopic NIR fluorescent optic device (Storz®), the SLN was located and removed (Fig. 1a, b). For these patients, data on the location of the SLN were prospectively recorded.Fig. 1


A Comparison of Radiocolloid and Indocyanine Green Fluorescence Imaging, Sentinel Lymph Node Mapping in Patients with Cervical Cancer Undergoing Laparoscopic Surgery.

Imboden S, Papadia A, Nauwerk M, McKinnon B, Kollmann Z, Mohr S, Lanz S, Mueller MD - Ann. Surg. Oncol. (2015)

a Right pelvic ICG-positive SLN as seen with laparoscopic NIR technology. b ICG-positive SLN as seen with laparoscopic NIR technology. ICG indocyanine green, NIR near infrared, SLN sentinel lymph node
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4644188&req=5

Fig1: a Right pelvic ICG-positive SLN as seen with laparoscopic NIR technology. b ICG-positive SLN as seen with laparoscopic NIR technology. ICG indocyanine green, NIR near infrared, SLN sentinel lymph node
Mentions: In Group 2, the patient was intracervically injected with 8–10 ml of ICG (Pulsion®) in the OR, immediately before laparoscopy. One vial of ICG (Pulsion®) had been previously suspended with 20 ml of sterile water. Under visual guidance of the fluorescent light using a laparoscopic NIR fluorescent optic device (Storz®), the SLN was located and removed (Fig. 1a, b). For these patients, data on the location of the SLN were prospectively recorded.Fig. 1

Bottom Line: Sensitivity, specificity, and overall and bilateral detection rates were calculated and compared.SLNs were ninefold more likely to be affected by metastatic disease compared with NSLNs (p < 0.005).Overall detection rates were 83 and 95.5 % (p = nonsignificant), and bilateral detection rates were 61 and 95.5 % (p < 0.005), for Groups 1 and 2, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland.

ABSTRACT

Background and purpose: (99)TC combined with blue-dye mapping is considered the best sentinel lymph node (SLN) mapping technique in cervical cancer. Indocyanine green (ICG) with near infrared fluorescence imaging has been introduced as a new methodology for SLN mapping. The aim of this study was to compare these two techniques in the laparoscopic treatment of cervical cancer.

Methods: Medical records of patients undergoing laparoscopic SLN mapping for cervical cancer with either (99)Tc and patent blue dye (Group 1) or ICG (Group 2) from April 2008 until August 2012 were reviewed. Sensitivity, specificity, and overall and bilateral detection rates were calculated and compared.

Results: Fifty-eight patients were included in the study-36 patients in Group 1 and 22 patients in Group 2. Median tumor diameter was 25 and 29 mm, and mean SLN count was 2.1 and 3.7, for Groups 1 and 2, respectively. Mean non-SLN (NSLN) count was 39 for both groups. SLNs were ninefold more likely to be affected by metastatic disease compared with NSLNs (p < 0.005). Sensitivity and specificity were both 100 %. Overall detection rates were 83 and 95.5 % (p = nonsignificant), and bilateral detection rates were 61 and 95.5 % (p < 0.005), for Groups 1 and 2, respectively. In 75 % of cases, SLNs were located along the external or internal iliac nodal basins.

Conclusions: ICG SLN mapping in cervical cancer provides high overall and bilateral detection rates that compare favorably with the current standard of care.

No MeSH data available.


Related in: MedlinePlus