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Practice of Fluorescence Navigation Surgery Using Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer

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ICG Fluorescence Imaging and Navigation Surgery

Abstract

The indocyanine green (ICG) navigation method enables a high detection rate and a low false-negative rate (FNR) in sentinel lymph node biopsy (SLNB). Unlike the blue dye-guided method (BD method), it emits a stronger fluorescence signal in the sentinel lymph node (SLN), contributing to its high detection rate and requiring less training. Unlike the radioisotope-guided (RI) method, it does not require radioactive colloids, expensive equipment, and legal permission. The ICG injection is diluted considering “quenching reaction,” and this dilution shows that enough sensitivity for SLN detection is attainable even at lower-dose ICG. Compression of the chest wall and axilla using hemispherical transplant device enables the identification of fluorescent SLN locations prior to the skin incision. The reduced FNR observed with the ICG method is due to its high detection rate of involvement SLNs and its ability to aid examination of more than one or two SLNs at anatomical order. This paper describes the current clinical practice of the ICG fluorescence navigation method and its availability compared to conventional methods (BD or RI method).

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Correspondence to Kazuhiko Yamagami .

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Yamagami, K., Deai, T., Matumoto, H., Hashimoto, T. (2016). Practice of Fluorescence Navigation Surgery Using Indocyanine Green for Sentinel Lymph Node Biopsy in Breast Cancer. In: Kusano, M., Kokudo, N., Toi, M., Kaibori, M. (eds) ICG Fluorescence Imaging and Navigation Surgery. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55528-5_9

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  • DOI: https://doi.org/10.1007/978-4-431-55528-5_9

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  • Publisher Name: Springer, Tokyo

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