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Fluorescent Versus Radioguided Lymph Node Mapping in Bladder Cancer.

Wojciech Polom1, Marcin Markuszewski1, Wojciech Cytawa2

  • 1Urology Department, Medical University of Gdańsk, Gdańsk, Poland.

Clinical Genitourinary Cancer
|December 24, 2016
PubMed
Summary

Indocyanine green (ICG) near-infrared fluorescence (NIRF) imaging is a safe and cost-effective method for sentinel lymph node biopsy (SLNB) in bladder cancer, detecting more lymph nodes than the traditional technetium radiocolloid (RadCol) method.

Keywords:
Bladder cancerIndocyanine greenLymphadenectomyNear-infrared fluorescenceSentinel lymph node biopsy

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Area of Science:

  • Urology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Sentinel lymph node biopsy (SLNB) is crucial for staging bladder cancer.
  • Accurate detection of lymph node metastasis is vital for treatment planning.

Purpose of the Study:

  • To compare the efficacy of indocyanine green (ICG) near-infrared fluorescence (NIRF) imaging versus technetium radiocolloid (RadCol) for SLNB in bladder cancer patients.
  • To evaluate the safety, cost-effectiveness, and detection rates of both SLNB methods.

Main Methods:

  • Fifty patients underwent SLNB using both RadCol (detected by gamma probe) and ICG (detected by NIRF camera).
  • Lymphadenectomy and pathological examination followed the SLNB procedure.
  • Data from 47 patients were analyzed after excluding 3 due to lack of lymphatic drainage.

Main Results:

  • ICG-NIRF detected all sentinel lymph nodes (SLNs) in 46 cases, while RadCol detected them in 45 cases.
  • ICG identified more SLNs than RadCol in 25.6% of patients.
  • Metastatic SLNs were found in 17% of patients using ICG; 6.4% of patients had SLNs outside the standard template, and 6.4% had negative SLNs but positive other lymph nodes.

Conclusions:

  • Both RadCol and ICG methods are effective for lymph node evaluation in bladder cancer via SLNB.
  • ICG-NIRF imaging is a safe, cost-effective technique offering live visualization.
  • ICG-NIRF imaging demonstrates a higher detection rate for SLNs compared to the radioactive method.