Skip to main content

Advertisement

SpringerLink
Log in

Molecular Targeted Fluorescence-Guided Intraoperative Imaging of Bladder Cancer Nodal Drainage Using Indocyanine Green During Radical and Partial Cystectomy

  • New Imaging Techniques (A Rastinehad and S Rais-Bahrami, Section Editors)
  • Published:
Current Urology Reports Aims and scope Submit manuscript

Abstract

Optical imaging is a relatively inexpensive, fast, and sensitive addition to a surgeon’s arsenal for the non-invasive detection of malignant dissemination. Optical cameras in the near infrared spectrum are able to successfully identify injected indocyanine green in lymphatic channels and sentinel lymph nodes. The use of this technology is now being used in the operating room to help with lymph node dissection and improve the prognosis of patients diagnosed with muscle invasive bladder cancer. Indocyanine green has the potential for many more applications due to its versatility. In the future, there is a potential to use it for lymphangiography during nephroureterctomy for upper tract urothelial carcinoma, adrenal surgery for partial or radical adrenalectomy. Further investigations at multiple centers will validate this technique and its efficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Vazina A et al. Stage specific lymph node metastasis mapping in radical cystectomy specimens. J Urol. 2004;171(5):1830–4.

    Article  PubMed  Google Scholar 

  2. Leissner J et al. Extended radical lymphadenectomy in patients with urothelial bladder cancer: results of a prospective multicenter study. J Urol. 2004;171(1):139–44.

    Article  CAS  PubMed  Google Scholar 

  3. Hawrysz DJ, Sevick-Muraca EM. Developments toward diagnostic breast cancer imaging using near-infrared optical measurements and fluorescent contrast agents. Neoplasia. 2000;2(5):388–417.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Jiang H, Ramesh S, Bartlett M. Combined optical and fluorescence imaging for breast cancer detection and diagnosis. Crit Rev Biomed Eng. 2000;28(3–4):371–5.

    Article  CAS  PubMed  Google Scholar 

  5. Ogawa M et al. In vivo molecular imaging of cancer with a quenching near-infrared fluorescent probe using conjugates of monoclonal antibodies and indocyanine green. Cancer Res. 2009;69(4):1268–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Becker A et al. Receptor-targeted optical imaging of tumors with near-infrared fluorescent ligands. Nat Biotechnol. 2001;19(4):327–31.

    Article  CAS  PubMed  Google Scholar 

  7. Liebert A et al. Non-invasive detection of fluorescence from exogenous chromophores in the adult human brain. Neuroimage. 2006;31(2):600–8.

    Article  CAS  PubMed  Google Scholar 

  8. Troyan SL et al. The FLARE intraoperative near-infrared fluorescence imaging system: a first-in-human clinical trial in breast cancer sentinel lymph node mapping. Ann Surg Oncol. 2009;16(10):2943–52.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Liedberg F et al. Intraoperative sentinel node detection improves nodal staging in invasive bladder cancer. J Urol. 2006;175(1):84–8. discussion 88–9.

    Article  PubMed  Google Scholar 

  10. Marits P et al. Detection of immune responses against urinary bladder cancer in sentinel lymph nodes. Eur Urol. 2006;49(1):59–70.

    Article  PubMed  Google Scholar 

  11. Sherif A et al. Lymphatic mapping and detection of sentinel nodes in patients with bladder cancer. J Urol. 2001;166(3):812–5.

    Article  CAS  PubMed  Google Scholar 

  12. Sherif A et al. Hybrid SPECT-CT: an additional technique for sentinel node detection of patients with invasive bladder cancer. Eur Urol. 2006;50(1):83–91.

    Article  PubMed  Google Scholar 

  13. Sevick-Muraca EM, Rasmussen JC. Molecular imaging with optics: primer and case for near-infrared fluorescence techniques in personalized medicine. J Biomed Opt. 2008;13(4):041303.

    Article  PubMed  PubMed Central  Google Scholar 

  14. de Boer A et al. Liver blood flow as a major determinant of the clearance of recombinant human tissue-type plasminogen activator. Thromb Haemost. 1992;67(1):83–7.

    PubMed  Google Scholar 

  15. Gurfinkel M et al. Pharmacokinetics of ICG and HPPH-car for the detection of normal and tumor tissue using fluorescence, near-infrared reflectance imaging: a case study. Photochem Photobiol. 2000;72(1):94–102.

    Article  CAS  PubMed  Google Scholar 

  16. Intes X et al. In vivo continuous-wave optical breast imaging enhanced with indocyanine green. Med Phys. 2003;30(6):1039–47.

    Article  PubMed  Google Scholar 

  17. Licha K et al. Hydrophilic cyanine dyes as contrast agents for near-infrared tumor imaging: synthesis, photophysical properties and spectroscopic in vivo characterization. Photochem Photobiol. 2000;72(3):392–8.

    Article  CAS  PubMed  Google Scholar 

  18. Hope-Ross M et al. Adverse reactions due to indocyanine green. Ophthalmology. 1994;101(3):529–33.

    Article  CAS  PubMed  Google Scholar 

  19. Obana A et al. Survey of complications of indocyanine green angiography in Japan. Am J Ophthalmol. 1994;118(6):749–53.

    Article  CAS  PubMed  Google Scholar 

  20. Jeschke S et al. Visualisation of the lymph node pathway in real time by laparoscopic radioisotope- and fluorescence-guided sentinel lymph node dissection in prostate cancer staging. Urology. 2012;80(5):1080–6.

    Article  PubMed  Google Scholar 

  21. Knapp DW et al. Sentinel lymph node mapping of invasive urinary bladder cancer in animal models using invisible light. Eur Urol. 2007;52(6):1700–8.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ishizawa T et al. Real-time identification of liver cancers by using indocyanine green fluorescent imaging. Cancer. 2009;115(11):2491–504.

    Article  PubMed  Google Scholar 

  23. Schaafsma BE et al. Optimization of sentinel lymph node mapping in bladder cancer using near-infrared fluorescence imaging. J Surg Oncol. 2014;110(7):845–50. First modern clinical study evaluating injetion techniques for indocyanine green during radical cystectomy.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Mieog JS et al. Toward optimization of imaging system and lymphatic tracer for near-infrared fluorescent sentinel lymph node mapping in breast cancer. Ann Surg Oncol. 2011;18(9):2483–91.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Manny TB, Krane LS, Hemal AK. Indocyanine green cannot predict malignancy in partial nephrectomy: histopathologic correlation with fluorescence pattern in 100 patients. J Endourol. 2013;27(7):918–21.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Manny TB, Patel M, Hemal AK. Fluorescence-enhanced robotic radical prostatectomy using real-time lymphangiography and tissue marking with percutaneous injection of unconjugated indocyanine green: the initial clinical experience in 50 patients. Eur Urol. 2014;65(6):1162–8.

    Article  PubMed  Google Scholar 

  27. Manny TB, Hemal AK. Fluorescence-enhanced robotic radical cystectomy using unconjugated indocyanine green for pelvic lymphangiography, tumor marking, and mesenteric angiography: the initial clinical experience. Urology. 2014;83(4):824–9. Modern study examining multiple uses of indocyanine green in bladder cancer using a robotic platform. Study demonstrates lymph node drainage as well as other concominant uses of ICG.

    Article  PubMed  Google Scholar 

  28. Menon M et al. Nerve-sparing robot-assisted radical cystoprostatectomy and urinary diversion. BJU Int. 2003;92(3):232–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC, 27157, USA

    Manish N. Patel & Ashok K. Hemal

Authors
  1. Manish N. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashok K. Hemal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manish N. Patel.

Ethics declarations

Conflict of Interest

Manish N. Patel and Ashok K. Hemal each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on New Imaging Techniques

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Patel, M.N., Hemal, A.K. Molecular Targeted Fluorescence-Guided Intraoperative Imaging of Bladder Cancer Nodal Drainage Using Indocyanine Green During Radical and Partial Cystectomy. Curr Urol Rep 17, 74 (2016). https://doi.org/10.1007/s11934-016-0633-z

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11934-016-0633-z

Keywords

Search

Navigation