Sentinel node navigation surgery using near-infrared indocyanine green fluorescence in early gastric cancer
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The aim of this study was to evaluate the feasibility of indocyanine green (ICG) fluorescent method for sentinel lymph node detection in early gastric cancer.
Between December 2012 and December 2014, 28 cases of pilot examination were performed at Seoul National University Bundang Hospital. Advanced version of multispectral fluorescence organoscope was used to identify sentinel node by quantitative estimation of ICG fluorescent signal intensity. Sensitivity, specificity, false positive value were analyzed and compared with dual tracer method.
A total of 443 lymph nodes in 28 cases were examined and 184 sentinel nodes (41.5%) were identified by dual tracer method. The sensitivity using near-infrared ICG method was 98.9%. The specificity was 76.0% and false positive rate was 25.4% compared with dual tracer method. The adequate threshold for sentinel node detection was considered as 10% of maximum signal intensity.
New near-infrared ICG fluorescent method could be a promising protocol for sentinel node navigation surgery in early gastric cancer.
KeywordsSentinel node navigation surgery Early gastric cancer ICG fluorescent signal intensity
This work was funded by the Seoul Metropolitan Government, Korea, under Contract of R & BD Program WR100001.
Compliance with ethical standards
Dong-Wook Kim, Bosu Jeong, Il-hyung Shin, Uk Kang, Yoontaek Lee, Young Suk Park, Sang-Hoon Ahn, Do Joong Park, and Hyung-Ho Kim have no conflicts of interest or financial ties to disclose.
The study was approved by Institutional Review Board of Seoul National University Bundang Hospital (registration number: E-1208/167007). The patients were fully informed of the study and filled out a written informed consent. This study was conducted according to the principles of the Declaration of Helsinki.
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