Young Min Park1, Yu Hua Quan2,3, Ki Hyeok Kwon4, Jae-Gu Cho1, Jeong-Soo Woo1, Beop-Min Kim4,5, Yun-Sang Lee6, Jae Min Jeong6, Hyun Koo Kim2,3, Jae-Jun Song1. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul, Republic of Korea. 2. Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, Seoul, Republic of Korea. 3. Department of Biomedical Sciences, College of Medicine, Korea University, Seoul, Republic of Korea. 4. Department of Interdisciplinary Bio/Micro System Technology, Korea University College of Engineering, Seoul, Republic of Korea. 5. Department of Bio-convergence Engineering, School of Biomedical Engineering, Korea University College of Health Science, Seoul, Republic of Korea. 6. Department of Nuclear Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
Abstract
OBJECTIVE: The aim of this study was to determine the possibility of endoscopic sentinel lymph node biopsy of the head and neck region using indocyanine green-neomannosyl human serum albumin (ICG:MSA) and a custom-made intraoperative color-and-fluorescence-merged imaging system (ICFIS). METHODS: Using mouse and rabbit models of tongue cancer, we performed sentinel lymph node biopsy using an ICG:MSA tracer and custom imaging system equipped with an endoscope. RESULTS: ICG:MSA was localized to the cervical lymph node on the ipsilateral side for up to 30 minutes compared to ICG tracer (ICG n = 3, IGC:MSA n = 3). Detection of sentinel lymph nodes was attempted after injecting ICG:MSA in the mouse tongue cancer model (n = 3). During the operation, lymph nodes were easily identified and resected using ICFIS without the aid of other magnifiers. In the rabbit tongue cancer model (n = 3), the ICFIS equipped with 30-degree endoscopy was used to confirm the feasibility of endoscopic sentinel lymph node biopsy. The entire sentinel lymph node biopsy procedure was performed using the ICFIS with the 30-degree endoscope. We detected and dissected sentinel lymph nodes in the rabbit model without the other sentinel lymph node detection tools. CONCLUSION: We confirmed the usefulness of sentinel lymph node biopsy using a near infrared fluorescence technique and endoscopic system. Avoidance of radiation exposure and shine-through phenomena, which are problems of sentinel lymph node biopsy using conventional radioisotopes, are advantages of our surgical technique. By combining the endoscopic system with a sentinel lymph node biopsy procedure, we avoided visible neck scars, which lead to excellent cosmetic outcomes. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:E135-E140, 2018.
OBJECTIVE: The aim of this study was to determine the possibility of endoscopic sentinel lymph node biopsy of the head and neck region using indocyanine green-neomannosyl humanserum albumin (ICG:MSA) and a custom-made intraoperative color-and-fluorescence-merged imaging system (ICFIS). METHODS: Using mouse and rabbit models of tongue cancer, we performed sentinel lymph node biopsy using an ICG:MSA tracer and custom imaging system equipped with an endoscope. RESULTS:ICG:MSA was localized to the cervical lymph node on the ipsilateral side for up to 30 minutes compared to ICG tracer (ICG n = 3, IGC:MSA n = 3). Detection of sentinel lymph nodes was attempted after injecting ICG:MSA in the mousetongue cancer model (n = 3). During the operation, lymph nodes were easily identified and resected using ICFIS without the aid of other magnifiers. In the rabbit tongue cancer model (n = 3), the ICFIS equipped with 30-degree endoscopy was used to confirm the feasibility of endoscopic sentinel lymph node biopsy. The entire sentinel lymph node biopsy procedure was performed using the ICFIS with the 30-degree endoscope. We detected and dissected sentinel lymph nodes in the rabbit model without the other sentinel lymph node detection tools. CONCLUSION: We confirmed the usefulness of sentinel lymph node biopsy using a near infrared fluorescence technique and endoscopic system. Avoidance of radiation exposure and shine-through phenomena, which are problems of sentinel lymph node biopsy using conventional radioisotopes, are advantages of our surgical technique. By combining the endoscopic system with a sentinel lymph node biopsy procedure, we avoided visible neck scars, which lead to excellent cosmetic outcomes. LEVEL OF EVIDENCE: NA. Laryngoscope, 128:E135-E140, 2018.
Authors: Nidal Muhanna; Harley H L Chan; Catriona M Douglas; Michael J Daly; Atul Jaidka; Donovan Eu; Jonathan Bernstein; Jason L Townson; Jonathan C Irish Journal: BMC Med Imaging Date: 2020-09-14 Impact factor: 1.930