Fluorescence Imaging Using Methylene Blue Sentinel Lymph Node Biopsy in Melanoma.

Area of Science:

• Oncology
• Surgical Innovation
• Medical Imaging

Background:

• Sentinel lymph node biopsy is crucial for melanoma staging.
• Fluorescence imaging offers novel visualization techniques.
• Methylene blue (MB) possesses fluorescent properties for potential surgical applications.

Purpose of the Study:

• To evaluate the clinical utility of methylene blue (MB) as a fluorescent dye for sentinel lymph node biopsy in melanoma patients.
• To present the first clinical series assessing MB for this indication.
• To explore the feasibility of MB-enhanced intraoperative visualization.

Main Methods:

• A prospective study involving 20 melanoma patients undergoing sentinel lymph node biopsy.
• Simultaneous administration of standard nanocolloid and methylene blue (MB).
• Assessment of transcutaneous, lymphatic channel, and sentinel node fluorescent visualization, including Signal to Background Ratio (SBR) calculations.

Main Results:

• Sentinel nodes were visualized by fluorescence in 65% of cases (median SBR 2.49).
• Lymphatic channels were visualized pre-clinically in 20% of patients (median SBR 3.69).
• Fluorescent sentinel nodes were visible transcutaneously in 15% of patients (median SBR 3.15).

Conclusions:

• Methylene blue (MB) is a viable fluorophore for sentinel lymph node biopsy in melanoma.
• This study is the first clinical series demonstrating MB's potential in this context.
• Further research is required to optimize clinical implementation strategies for MB-guided sentinel node biopsy.