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Table of Contents
Vol. 25, No. 2, 2008
Issue release date: May 2008
Section title: Original Paper
Dig Surg 2008;25:103–108
(DOI:10.1159/000121905)

Sentinel Node Mapping Guided by Indocyanine Green Fluorescence Imaging: A New Method for Sentinel Node Navigation Surgery in Gastrointestinal Cancer

Kusano M. · Tajima Y. · Yamazaki K. · Kato M. · Watanabe M. · Miwa M.
aDivision of General and Gastroenterological Surgery, Department of Surgery, Showa University, School of Medicine, Tokyo, and bCentral Laboratory, Hamamatsu Photonicus, Shizuoka, Japan

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/11/2007
Accepted: 9/13/2007
Published online: 3/28/2008

Number of Print Pages: 6
Number of Figures: 4
Number of Tables: 3

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU

Abstract

Background: Recently, gastrointestinal cancer has also been identified as a target for sentinel node navigation surgery (SNNS). This study is the first to determine the feasibility of sentinel node (SN) mapping guided by indocyanine green (ICG) fluorescence imaging in gastrointestinal cancer. Methods: Our series consisted of 22 patients with gastric cancer and 26 patients with colorectal cancer who had undergone standard surgical resection. ICG solution was injected intraoperatively into the subserosa around the tumor. Fluorescence imaging was obtained by a charge-coupled device (CCD) camera with a light-emitting diode with a wavelength of 760 nm as the light source and a cut filter to filter out light with wavelengths below 820 nm as the detector. Results: Immediately after the ICG injection, lymphatic vessels draining the tumor and round-shaped SNs were visualized by their bright fluorescence. Even SNs that were not green in color could be easily and clearly visualized by ICG fluorescence imaging. The SN detection rate and mean number of SNs were 90.9% and 3.6 ± 4.5 (mean ± SD), respectively, in patients with gastric cancer, and 88.5% and 2.6 ± 2.4, respectively, in patients with colorectal cancer. Among the patients with gastric cancer, the accuracy and false-negative rates were 88.9 and 33.3%, respectively, in patients with T1 stage cancer, and 70.0 and 60.0%, respectively, overall, in all the patients. Among the patients with colorectal cancer, the corresponding values were 100 and 0%, respectively, in patients with T1 stage cancer, and 82.6 and 66.7%, respectively, overall, in all the patients. Conclusions: Our preliminary results show that ICG fluorescence imaging allows easy, highly sensitive and real-time imaging-guided SN mapping in patients with gastric or colorectal cancer. SN mapping guided by ICG fluorescence imaging could be a promising tool deserving further clinical exploration.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 7/11/2007
Accepted: 9/13/2007
Published online: 3/28/2008

Number of Print Pages: 6
Number of Figures: 4
Number of Tables: 3

ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)

For additional information: http://www.karger.com/DSU


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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