BACKGROUND AND OBJECTIVES: Sentinel lymph node (SLN) biopsy has become the standard method of determining regional lymph node involvement in cutaneous melanoma. Although traditionally performed via injection of radioisotope tracers and blue dyes, fluorescent lymphangiography with indocyanine green (ICG) is an attractive alternative. METHODS: Fifty two consecutive patients with cutaneous melanoma of the trunk or extremities underwent SLNB. Preoperative lymphoscintigraphy was performed with technetium-99m sulfur colloid (TSC). Peritumoral intradermal injection of isosulfan blue (ISB) and ICG was then performed. Successful identification of a sentinel lymph node via each modality was then assessed. RESULTS: A total of 77 lymph nodes were identified from the 52 patients (range 1-3). The majority of melanomas were extremity-based, superficial spreading type, and had SLN localized to the axilla. There were no complications related to IcG administration. Rates of SLN detection were 96.2% for TSC, 59.6% for ISB, and 88.5% for IcG (P < 0.05 for ICG vs ISB). On univariate logistic regression analysis, no factors were found to be associated with failure of ICG. CONCLUSIONS: Fluorescent lymphangiography using ICG is an effective method of SLN identification in patients with cutaneous melanoma of the trunk and extremities. When ICG and TSC are used in combination, ISB offers no additional advantage and may be safely omitted.
BACKGROUND AND OBJECTIVES: Sentinel lymph node (SLN) biopsy has become the standard method of determining regional lymph node involvement in cutaneous melanoma. Although traditionally performed via injection of radioisotope tracers and blue dyes, fluorescent lymphangiography with indocyanine green (ICG) is an attractive alternative. METHODS: Fifty two consecutive patients with cutaneous melanoma of the trunk or extremities underwent SLNB. Preoperative lymphoscintigraphy was performed with technetium-99m sulfur colloid (TSC). Peritumoral intradermal injection of isosulfan blue (ISB) and ICG was then performed. Successful identification of a sentinel lymph node via each modality was then assessed. RESULTS: A total of 77 lymph nodes were identified from the 52 patients (range 1-3). The majority of melanomas were extremity-based, superficial spreading type, and had SLN localized to the axilla. There were no complications related to IcG administration. Rates of SLN detection were 96.2% for TSC, 59.6% for ISB, and 88.5% for IcG (P < 0.05 for ICG vs ISB). On univariate logistic regression analysis, no factors were found to be associated with failure of ICG. CONCLUSIONS: Fluorescent lymphangiography using ICG is an effective method of SLN identification in patients with cutaneous melanoma of the trunk and extremities. When ICG and TSC are used in combination, ISB offers no additional advantage and may be safely omitted.
Authors: Alisha V DSouza; Jonathan T Elliott; Jason R Gunn; Richard J Barth; Kimberley S Samkoe; Kenneth M Tichauer; Brian W Pogue Journal: Biomed Opt Express Date: 2015-03-17 Impact factor: 3.732
Authors: Sergi Vidal-Sicart; Fijs W B van Leeuwen; Nynke S van den Berg; Renato A Valdés Olmos Journal: Eur J Nucl Med Mol Imaging Date: 2015-07-22 Impact factor: 9.236
Authors: Sara Imboden; Andrea Papadia; Mélina Nauwerk; Brett McKinnon; Zahraa Kollmann; Stefan Mohr; Susanne Lanz; Michael D Mueller Journal: Ann Surg Oncol Date: 2015-06-30 Impact factor: 5.344
Authors: Charlotte M C Oude Ophuis; Lisa B Koppert; Cécile de Monyé; Carolien H M van Deurzen; Senada Koljenović; Alexander C J van Akkooi; Cornelis Verhoef; Dirk J Grünhagen Journal: BMC Cancer Date: 2017-04-12 Impact factor: 4.430