Indocyanine Green Fluorescence Imaging for Sentinel Node Mapping in Gastric Cancer~!2009-10-31~!2009-12-23~!2010-05-26~!

Abstract

Background: Indocyanine green (ICG) fluorescence imaging has recently been reported as a new method for sentinel node (SN) mapping in several types of cancers. In this study, we determined the feasibility and accuracy of SN mapping guided by ICG fluorescence imaging in gastric cancer. Methods: Our series consisted of 84 patients with gastric cancer who had undergone standard gastrectomy with lymphadenectomy. Intraoperative SN mapping guided by ICG fluorescence imaging was conducted using a chargecoupled device camera with a light-emitting diode as the light source and a cut filter as the detector. Results: The detection rate and mean number of SNs were 97.6% and 7.5, respectively. The accuracy and false-negative rates were 91.5% and 33.3%, respectively. The false-negative result was significantly associated with an intraoperative tracer injection, larger number of cT-stage and pT-stage (P = 0.0012, P = 0.0003, and P = 0.0062, respectively). Lymph node metastasis outside the lymphatic basins was never found in 59 patients with cT1-2 stage gastric cancer who had received preoperative ICG injection. Conclusions: ICG fluorescence imaging-guided SN mapping with preoperative ICG injection can be useful for predicting the metastatic status in the lymph nodes in gastric cancer.