Lipid Nanoparticle Vectorization of IndoCyanine Green Improves Fluorescence Imaging for Tumor Diagnosis and Lymph Node Resection

2012 ◽  
Vol 8 (5) ◽  
pp. 730-741 ◽  
Author(s):  
Fabrice P. Navarro ◽  
Michel Berger ◽  
Stéphanie Guillermet ◽  
Véronique Josserand ◽  
Laurent Guyon ◽  
...  
Keyword(s):  
Lymph Node ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Tumor Diagnosis ◽  
Lymph Node Resection ◽  
Lipid Nanoparticle

A novel approach for sentinel lymph node identification using fluorescence imaging and image overlay navigation surgery in patients with breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 624-624
Author(s):  
N. Tagaya ◽  
A. Abe ◽  
M. Tachibana ◽  
K. Kubota
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Mixed Reality ◽  
Operation Time ◽  
Skin Incision ◽  
Accurate Identification ◽  
Navigation Surgery ◽  
Image Overlay

624 Background: We reported a novel technique of sentinel lymph node (SLN) identification using fluorescence imaging of indocyanine green injection. Furthermore, to obtain safe and accurate identification of SLN during surgery, we introduce the image overlay navigation surgery and evaluate its efficacy. Methods: This study enrolled 30 patients with a tumor less than 3 cm in diameter. Initially we obtained three-dimensional (3-D) imaging from MD-CT by volume rendering of Osirix (Macintosh, Apple Inc.). It was projected on the patient’ operative field with the clear visualization of LN through the micro projector (Mpro 110, Sumitomo 3M). And then the dye of indocyanine green was injected subdermally in the areola. Subcutaneous lymphatic channels draining from the areola to the axilla were visible by fluorescence imagings (Photodynamic eye: PDE, Hamamatsu Photonics Co.) immediately. Lymphatic flow was reached after LN revealed on 3-D imaging. After incising the axillary skin on the point of LN mapping, SLN was then dissected under the guidance of fluorescence and 3-D imaging with adequate adjustment of sensitivity. Results: Lymphatic channels and SLN were successfully identified by PDE in all patients. And the sites of skin incision were also identical with the LN being demonstrated by 3-D imaging in all patients. The mean number of SLN was 2.8. The adjustment of sensitivity of PDE provide with the reduction of operation time. The image overlay navigation surgery was visually easy to identify the location of SLN from the axillary skin. There were no intra- or postoperative complications associated with SLN identification. Conclusions: This combined navigations of fluorescence and 3-D imagings revealed more easy and effective to detect SLN intraoperatively than fluorescence imaging alone. The operator's demand was satisfied with the introduction of image overlay navigation surgery consisted of augmented reality and mixed reality, and it may be practical in the various surgical fields. No significant financial relationships to disclose.

scholarly journals Systemic Sentinel Lymph Node Detection Using Fluorescence Imaging After Indocyanine Green Intravenous Injection in Colorectal Cancer: Protocol for a Feasibility Study

10.2196/17976 ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. e17976 ◽  
Author(s):  
Gabriel Liberale ◽  
Sophie Vankerckhove ◽  
Fikri Bouazza ◽  
Maria Gomez Galdon ◽  
Denis Larsimont ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Sentinel Lymph Nodes ◽  
Nodal Staging ◽  
Sentinel Lymph Node Detection ◽  
Indocyanine Green Dye

Background Nodal staging is a major concern in colorectal cancer as it is an important prognostic factor. Several techniques that could potentially improve patient treatment and prognosis have been developed to increase the accuracy of nodal staging. Sentinel lymph node detection has been shown to accurately reflect nodal status in various tumors and has become the standard procedure in nodal staging of breast cancer and melanoma. However, in colorectal cancer, sentinel lymph node detection techniques are still controversial as the sensitivity reported in the literature varies from one study to another. Recently, indocyanine green fluorescence–guided surgery has been reported to be a useful technique for detection of macroscopic and microscopic metastatic deposits in lymph nodes after intravenous administration of indocyanine green dye. However, no studies have focused on the potential role of sentinel lymph node detection after systemic administration of indocyanine green dye, so-called systemic sentinel lymph nodes, or on the correspondence between the identification of the sentinel lymph node by standard local injection techniques and the detection of fluorescent lymph nodes with this new approach. Objective The aim of this protocol is to validate the concept of sentinel lymph nodes identified by fluorescence imaging after intravenous injection of indocyanine green dye and to compare the sentinel lymph nodes identified by fluorescence imaging with sentinel lymph nodes detected by the standard blue dye technique. Methods This study (SeLyNoFI; Sentinel Lymph Nodes Fluorescence Imaging) is a diagnostic, single-arm, open-label feasibility study, including patients with colorectal adenocarcinoma with or without metastatic disease who are admitted for elective colorectal resection of the primary tumor. This study evaluates the feasibility of a new approach for improving the accuracy of nodal staging using fluorescence imaging after intravenous administration of indocyanine green dye. Sensitivity, positive predictive value, and accuracy of the classical blue dye technique and of the investigatory fluorescence imaging technique will be calculated. Translational research will be proposed, if applicable. Results As of June 2020, this study has been registered. Submission for ethical review is planned for September 2020. Conclusions The potential correlation between the two different approaches to detect sentinel lymph nodes offers new strategies for improving the accuracy of nodal staging in colorectal cancer. This new concept of the systemic sentinel lymph node and a greater understanding of the interactions between systemic sentinel lymph nodes and standard sentinel lymph nodes may provide important information regarding the underlying mechanism of primary tumor lymphatic drainage. The enhanced permeability and retention effect can also play a role in the fluorescence of systemic sentinel lymph nodes, especially if these lymph nodes are inflamed. In this case, we can even imagine that this new technique will highlight more instances of lymph node–positive colorectal cancer. International Registered Report Identifier (IRRID) PRR1-10.2196/17976

scholarly journals A Comparison of the Detection of Sentinel Lymph Nodes Using Indocyanine Green and Near-Infrared Fluorescence Imaging Versus Blue Dye During Robotic Surgery in Uterine Cancer

2017 ◽  
Vol 27 (4) ◽  
pp. 743-747 ◽  
Author(s):  
Ane Gerda Eriksson ◽  
Anna Beavis ◽  
Robert A. Soslow ◽  
Qin Zhou ◽  
Nadeem R. Abu-Rustum ◽  
...  
Keyword(s):  
Lymph Node ◽  
Indocyanine Green ◽  
Fluorescence Imaging ◽  
Detection Rate ◽  
Near Infrared ◽  
Uterine Cancer ◽  
Blue Dye ◽  
Robotic Platform ◽  
Near Infrared Fluorescence ◽  
Near Infrared Fluorescence Imaging

ObjectivesThe objective of this study was to assess and compare the sentinel lymph node (SLN) detection rate with indocyanine green (ICG) and near-infrared fluorescence imaging versus blue dye using the robotic platform in patients with uterine cancer.MethodsWe identified all patients with uterine cancer undergoing SLN mapping using ICG or blue dye on the robotic platform from January 2011 to December 2013. Our institutional SLN algorithm and pathologic processing protocol were adhered to uniformly. We compared detection rates of SLNs stratified by dye used. Appropriate statistical tests were used.ResultsA total of 472 patients were identified. ICG was used in 312 patients (66%) and blue dye in 160 patients (34%). Successful mapping was achieved in 425 (90%) of 472 patients. Mapping was bilateral in 352 patients (75%) and unilateral in 73 patients (15%); 47 patients (10%) did not map. Successful mapping was achieved in 295 (95%) of 312 patients using ICG compared with 130 (81%) of 160 patients using blue dye (P < 0.001). Mapping was bilateral in 266 (85%) of 312 patients in the ICG group compared with 86 (54%) of 160 in the blue dye group (P < 0.001). Additional lymph node dissection beyond removal of the SLNs was performed in 122 patients (39%) mapped with ICG compared with 98 patients (61%) mapped with blue dye (P < 0.001).ConclusionsThe SLN detection rate was superior when mapping with ICG rather than blue dye. Bilateral mapping was significantly improved, resulting in a lower rate of additional lymphadenectomy.

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