TY - JOUR
T1 - Intraoperative multispectral fluorescence imaging for the detection of the sentinel lymph node in cervical cancer
T2 - A novel concept
AU - Crane, Lucia M.A.
AU - Themelis, George
AU - Pleijhuis, Rick G.
AU - Harlaar, Niels J.
AU - Sarantopoulos, Athanasios
AU - Arts, Henriette J.G.
AU - Van Der Zee, Ate G.J.
AU - Vasilis, Ntziachristos
AU - Van Dam, Gooitzen M.
PY - 2011/10
Y1 - 2011/10
N2 - Purpose: Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer. Procedures: In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system. Results: Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases. Conclusions: We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity.
AB - Purpose: Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer. Procedures: In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system. Results: Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases. Conclusions: We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity.
KW - Cervical cancer
KW - Multispectral intraoperative imaging
KW - Near-infrared fluorescence
KW - Sentinel lymph node
UR - http://www.scopus.com/inward/record.url?scp=80455126134&partnerID=8YFLogxK
U2 - 10.1007/s11307-010-0425-7
DO - 10.1007/s11307-010-0425-7
M3 - Article
C2 - 20835767
AN - SCOPUS:80455126134
SN - 1536-1632
VL - 13
SP - 1043
EP - 1049
JO - Molecular Imaging and Biology
JF - Molecular Imaging and Biology
IS - 5
ER -
