Background: The equipment to detect indocyanine green (ICG) fluorescence for sentinel lymph node (SLN) biopsy in breast cancer is not widely accessible nor optimal. The fluorescence appears as a poorly defined white shine on a black background, and dimmed lighting is required. The aim of this study was to assess the feasibility, accuracy and healthcare costs of a novel approach for SLN biopsy by a video-assisted ICG-guided technique. Methods: The technique for detecting SLN was radioisotope (RI) in 194 cases, video-assisted ICG-guided in 70 cases, and a combined method in 71 cases. In the video-assisted ICG group a full HD laparoscopic system equipped with Xenon lamps was used for a laser-free detection of ICG within a colored and magnified high-resolution image. Results: Detection of ICG fluorescence using a laparoscope with a near-infrared filter provided a highly-defined and coloured image during SLN biopsy. SLN was identified in 100% of patients in all groups. Multiple SLNs were identified in 0.5% of RI patients, in 12.9% of ICG patients and in 14.1% of ICG+RI patients (p<0.0001). In ICG + RI group, 95.1% of lymph nodes were radioactive and 92.7% were fluorescent. Operative times and healthcare costs were equivalent between groups. Conclusions: Video-assisted ICG-guided technique is a feasible and surgeon-friendly method for SLN biopsy, with equivalent efficacy compared to RI, providing an accurate staging of the axilla.

A novel indocyanine green fluorescence-guided video-assisted technique for sentinel node biopsy in breast cancer / L. Sorrentino, A. Sartani, G. Pietropaolo, D. Bossi, S. Mazzucchelli, M. Truffi, D. Foschi, F. Corsi. - In: WORLD JOURNAL OF SURGERY. - ISSN 0364-2313. - (2018 Feb 05). [Epub ahead of print]

A novel indocyanine green fluorescence-guided video-assisted technique for sentinel node biopsy in breast cancer

Sorrentino, Luca;Sartani, Alessandra;PIETROPAOLO, GAIA;Mazzucchelli, Serena;Truffi, Marta;Foschi, Diego;Corsi, Fabio
2018-02-05

Abstract

Background: The equipment to detect indocyanine green (ICG) fluorescence for sentinel lymph node (SLN) biopsy in breast cancer is not widely accessible nor optimal. The fluorescence appears as a poorly defined white shine on a black background, and dimmed lighting is required. The aim of this study was to assess the feasibility, accuracy and healthcare costs of a novel approach for SLN biopsy by a video-assisted ICG-guided technique. Methods: The technique for detecting SLN was radioisotope (RI) in 194 cases, video-assisted ICG-guided in 70 cases, and a combined method in 71 cases. In the video-assisted ICG group a full HD laparoscopic system equipped with Xenon lamps was used for a laser-free detection of ICG within a colored and magnified high-resolution image. Results: Detection of ICG fluorescence using a laparoscope with a near-infrared filter provided a highly-defined and coloured image during SLN biopsy. SLN was identified in 100% of patients in all groups. Multiple SLNs were identified in 0.5% of RI patients, in 12.9% of ICG patients and in 14.1% of ICG+RI patients (p<0.0001). In ICG + RI group, 95.1% of lymph nodes were radioactive and 92.7% were fluorescent. Operative times and healthcare costs were equivalent between groups. Conclusions: Video-assisted ICG-guided technique is a feasible and surgeon-friendly method for SLN biopsy, with equivalent efficacy compared to RI, providing an accurate staging of the axilla.
sentinel lymph node biopsy; breast cancer; indocyanine green
Settore MED/18 - Chirurgia Generale
Settore BIO/10 - Biochimica
Settore BIO/12 - Biochimica Clinica e Biologia Molecolare Clinica
Settore BIO/13 - Biologia Applicata
Settore BIO/11 - Biologia Molecolare
5-feb-2018
WORLD JOURNAL OF SURGERY
Article (author)
File in questo prodotto:
File Dimensione Formato  
Manuscript ICG WJS.pdf

non disponibili

Descrizione: Articolo principale
306.39 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
10.1007_s00268-018-4534-9.pdf

non disponibili

1.02 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/551763
Citazioni
  • ???jsp.display-item.citation.pmc??? 6
  • Scopus 16
  • ???jsp.display-item.citation.isi??? 17
social impact