Indocyanine Green Marking of Axillary Sentinel Lymph Nodes in Early Breast Cancer.

IF 2.4 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Geburtshilfe Und Frauenheilkunde Pub Date : 2024-11-12 eCollection Date: 2025-06-01 DOI:10.1055/a-2436-1699

Steffi Hartmann, Meri-Liis Plonus, Gesche Schultek, Johannes Stubert, Bernd Gerber, Toralf Reimer

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引用次数: 0

Abstract

Introduction: Axillary sentinel lymph node excision (SLNE) in breast cancer patients with clinically node-negative disease may be carried out using different tracers. The standard tracer is technetium colloid ( ^99m Tc). Indocyanine green (ICG) can be used as an alternative. This study aimed to evaluate the clinical usefulness of this fluorescent dye in a standardized setting.

Material and methods: A prospective, single-center cohort study carried out at the University Gynecological Hospital of Rostock from September 2023 to May 2024 carried out sentinel lymph node marking using only ICG in patients with breast malignancies. The ICG injection was administered immediately after the induction of anesthesia. Detection of the sentinel lymph node (SLN) was done using a laparoscopy system suitable for ICG. The aim was to determine the detection rate (DR) for SLNs marked exclusively using ICG and to record any complications. The costs of using ICG to mark SLNs were compared with those for ^99m Tc marking.

Results: During the study period, contraindications against marking with ICG were ascertained for five (3.8%) of 132 patients with planned SLNE. A total of 100 SLNEs were carried out after ICG marking in patients who met the inclusion criteria in the context of the study. A median of two SLNs were resected. The detection rate (DR) for SLNs was 98.0%. SLNs were identified in all obese patients. No serious systemic side effects occurred following ICG injection. Transient skin discoloration in the area around the injection site were observed in eight patients. The direct cost of ICG marking was 62.73 Euros, which was 170.36 Euros lower than the cost of ^99m Tc marking.

Conclusion: The detection rate of axillary SLNs marked using ICG is high and the method is cost-effective, has few side effects and can also be used in obese patients. Contraindications against the administration of ICG are rare. Marking with ICG is a good alternative to the ^99m Tc method and offers advantages in terms of costs, logistics, no exposure to radiation, and patient comfort.

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早期乳腺癌腋窝前哨淋巴结的吲哚菁绿标记。

临床淋巴结阴性的乳腺癌患者腋窝前哨淋巴结切除术（SLNE）可以使用不同的示踪剂进行。标准示踪剂为锝胶体（99m Tc）。吲哚菁绿（ICG）可作为替代品。本研究旨在评估这种荧光染料在标准化环境下的临床应用价值。材料和方法：一项前瞻性、单中心队列研究于2023年9月至2024年5月在罗斯托克大学妇科医院进行，仅使用ICG对乳腺恶性肿瘤患者进行前哨淋巴结标记。麻醉诱导后立即注射ICG。使用适合ICG的腹腔镜系统检测前哨淋巴结（SLN）。目的是确定仅使用ICG标记的sln的检出率（DR），并记录任何并发症。使用ICG标记sln的成本与使用9900万Tc标记的成本进行了比较。结果：在研究期间，132例计划SLNE患者中有5例（3.8%）确定了ICG标记的禁忌症。在符合本研究纳入标准的患者中，ICG标记后共进行了100例slne。中位数为2个sln被切除。sln的检出率（DR）为98.0%。在所有肥胖患者中均发现sln。注射ICG后未发生严重的全身副作用。8例患者在注射部位周围出现短暂性皮肤变色。ICG打标的直接成本为62.73欧元，比9900万Tc打标的成本低170.36欧元。结论：ICG标记腋窝sln检出率高，成本低，副作用少，可用于肥胖患者。ICG的禁忌症是罕见的。ICG标记是99m Tc方法的一个很好的替代方案，在成本、物流、不暴露于辐射和患者舒适度方面具有优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Geburtshilfe Und Frauenheilkunde 医学-妇产科学

CiteScore

2.50

自引率

22.20%

发文量

828

审稿时长

6-12 weeks

期刊介绍： Geburtshilfe und Frauenheilkunde (GebFra) addresses the whole field of obstetrics and gynecology and is concerned with research as much as with clinical practice. In its scientific section, it publishes original articles, reviews and case reports in all fields of the discipline, namely gynecological oncology, including oncology of the breast obstetrics and perinatal medicine, reproductive medicine, and urogynecology. GebFra invites the submission of original articles and review articles. In addition, the journal publishes guidelines, statements and recommendations in cooperation with the DGGG, SGGG, OEGGG and the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF, Association of Scientific Medical Societies, www.awmf.org). Apart from the scientific section, Geburtshilfe und Frauenheilkunde has a news and views section that also includes discussions, book reviews and professional information. Letters to the editors are welcome. If a letter discusses an article that has been published in our journal, the corresponding author of the article will be informed and invited to comment on the letter. The comment will be published along with the letter.