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Updated: Jun 3, 2026
Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
The usefulness of photodynamic eye for sentinel lymph node identification in patients with cervical cancer
Naoto Furukawa1, Hidekazu Oi, Shozo Yoshida
1Department of Obstetrics and Gynecology, Nara Medical University 840 Shijo-cho, Kashihara, Nara 634-8522, Japan. furunao@hotmail.com
Aims And Background:
We studied the potential use of sentinel lymph node identification using a near-infrared fluorescence imaging technique in the treatment of cervical cancer.
Methods And Study Design:
Directly before the start of the operation, 0.2 ml of 5 mg/ml indocyanine green was prepared and injected into 4 sites in the cervix using a 26-gauge standard needle, at 3, 6, 9 and 12 o'clock positions. When the operation was advanced to the pelvis, near-infrared fluorescence imaging was performed using photodynamic eye (Hamamatsu Photonics Co., Japan). The sentinel lymph nodes and other dissected lymph nodes were histologically examined to find any metastases.
Results:
Twelve patients were examined. Their ages ranged from 36 to 68 years (median, 58). Sentinel lymph nodes were identified in 10 patients (83%), and all were bilaterally identified. The median maximum tumor diameter of dissected cervical tumors was 35 mm (22-65); histology was squamous cell carcinoma in 8 patients and adenocarcinoma in 2 patients. Capillary lymphatic space involvement was found in 8 of the 10 patients. The site of the sentinel lymph node was the right external iliac node in 8 patients, the right obturator node in 8, the left external iliac node in 9, and the left obturator node in 8. Lymph node metastasis was found in 2 of the 12 patients, and all were sentinel lymph nodes. No metastasis from lymph nodes other than sentinel lymph nodes was observed.
Conclusions:
Photodynamic eye achieved a detection rate similar to that obtained with the blue dye and radioisotope method. It is also easier to use than the other two methods.
Insights
Near-infrared fluorescence imaging effectively identifies sentinel lymph nodes in cervical cancer patients, aiding metastasis detection. This technique offers a simpler alternative to traditional methods for precise surgical guidance.
Area of Science:
- Oncology
- Surgical Innovation
- Medical Imaging
Background:
- Cervical cancer treatment relies on accurate staging, including lymph node assessment.
- Sentinel lymph node biopsy is crucial for detecting metastasis.
- Current methods for sentinel lymph node identification can be complex.
Purpose of the Study:
- To evaluate the efficacy of near-infrared fluorescence imaging for sentinel lymph node identification in cervical cancer.
- To assess the feasibility and accuracy of the Photodynamic Eye system in this context.
- To compare this novel technique with established methods.
Main Methods:
- Indocyanine green dye was injected into four cervical sites before surgery.
- Near-infrared fluorescence imaging using the Photodynamic Eye system was employed to visualize sentinel lymph nodes.
- Sentinel and other dissected lymph nodes underwent histological examination for metastases.
Main Results:
- Sentinel lymph nodes were successfully identified in 83% of 12 patients.
- Metastasis was detected in 2 patients, exclusively within the sentinel lymph nodes.
- The technique demonstrated high accuracy in localizing metastatic lymph nodes.
Conclusions:
- Near-infrared fluorescence imaging with Photodynamic Eye is a viable method for sentinel lymph node identification in cervical cancer.
- This technique achieves detection rates comparable to blue dye and radioisotope methods.
- The system offers improved ease of use compared to existing techniques.
