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Updated: May 10, 2026
Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
Real-time lymphography by indocyanine green fluorescence: improved navigation for regional lymph node staging
Christoph Hirche1, Holger Engel, Zarah Hirche
1From the *Department of Hand, Plastic, and Reconstructive Surgery, Trauma Centre Ludwigshafen, Department of Plastic and Hand Surgery, University of Heidelberg, Heidelberg, Germany; †Department of General Surgery and Surgical Oncology, Helios Hospital Berlin-Buch, Berlin, Germany; and ‡Department of Radiology, Helios Hospital Berlin-Buch, Berlin, Germany.
Indocyanine green (ICG) fluorescence imaging accurately identifies lymphatic vessels and sentinel lymph nodes (SLNs) in 96% of patients with solid tumors. This technique offers a reliable method for regional lymph node staging across various cancer types.
Area of Science:
- Oncology
- Medical Imaging
- Surgical Navigation
Background:
- Accurate lymph node staging is crucial for solid malignancies.
- Current diagnostic tools for lymph node identification have limitations.
- Indocyanine green (ICG) offers potential for enhanced lymphatic imaging.
Purpose of the Study:
- To validate indocyanine green (ICG) guided transcutaneous and transmesenterial navigation.
- To assess ICG's accuracy in identifying lymph vessels and nodes for staging.
- To evaluate ICG for regional lymph node staging in solid malignancies.
Main Methods:
- A planar fluorescence imaging system was used for lymphography and lymph node detection with ICG.
- 96 patients underwent fluorescence navigation for axillary, inguinal, and mesenteric lymph node visualization.
- The study analyzed the technical and clinical feasibility of ICG navigation.
Main Results:
- ICG fluorescence imaging identified lymphatic vessels and SLNs in 92/96 patients (96% detection rate).
- Sensitivity for ICG navigation was 95.6% in patients with lymph node dissection.
- The method proved feasible for a broad spectrum of solid tumors.
Conclusions:
- ICG-guided real-time lymphography provides accurate visualization for regional lymph node staging in various solid tumors.
- The technique is applicable for lymphography in non-malignant diseases.
- The broad applicability justifies institutional investment in fluorescence imaging equipment.