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Area of Science:

  • Oncology
  • Surgical Innovation
  • Medical Imaging

Background:

  • Sentinel lymph node mapping has evolved significantly since its inception in 1977.
  • Various dyes and radiotracers are validated for breast, vulvar, cervical cancers, and melanoma.
  • Mapping protocols are tailored to specific tumor site anatomy.

Purpose of the Study:

  • To review the evolution of tracers and detection devices for sentinel lymph node mapping.
  • To provide an exhaustive review of current clinical indications, particularities, and adverse effects.
  • To present an update on ongoing clinical studies in sentinel lymph node mapping methods.

Main Methods:

  • Review of historical and current tracers (dyes, radiotracers, indocyanine green).
  • Discussion of detection devices and imaging techniques, including near-infrared fluorescence imaging.
  • Analysis of established and emerging mapping protocols for different cancer types.

Main Results:

  • Established methods for breast, vulvar cancer, and melanoma include radiotracer/blue dye combinations or radiotracer alone.
  • Indocyanine green is gaining popularity for pelvic sentinel lymph node mapping.
  • Near-infrared fluorescence imaging is an FDA-approved, real-time image-guided technique.

Conclusions:

  • Continuous investigation of new tracers and devices aims to enhance lymphatic drainage understanding.
  • The goal is to increase the sensitivity and specificity of sentinel lymph node mapping.
  • The review offers a comprehensive overview of current practices and future directions in the field.