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Multispectral Real-time Fluorescence Imaging for Intraoperative Detection of the Sentinel Lymph Node in Gynecologic Oncology
Published on: October 20, 2010
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Different tracers for sentinel node detection in gynecologic oncology
Joel Laufer1, Santiago Scasso1, Andrea Papadia2,3
1Department of Gynaecology. Gynecologic Oncology Unit, Hospital Británico, Montevideo Uruguay.
Current Opinion in Oncology
|July 15, 2024
Summary
Indocyanine green (ICG) fluorescence imaging is the preferred tracer for sentinel lymph node (SLN) mapping in most gynecologic cancers. However, radioactive tracers remain standard for early-stage vulvar cancer SLN biopsy.
Area of Science:
- Gynecologic Oncology
- Surgical Oncology
- Nuclear Medicine
Background:
- Sentinel lymph node (SLN) mapping has become a standard procedure, largely replacing complete lymphadenectomies in gynecologic oncology over the last decade.
- This shift is driven by the need for accurate staging while minimizing surgical morbidity.
Purpose of the Study:
- To review the latest literature on sentinel lymph node mapping techniques in gynecologic oncology.
- To evaluate the efficacy of different tracers, particularly indocyanine green (ICG), in SLN mapping for various gynecologic malignancies.
Main Methods:
- Comprehensive literature review of recent studies on SLN mapping in gynecologic cancers.
- Analysis of tracer performance, focusing on indocyanine green (ICG) and technetium-99m (Tc-99m).
Main Results:
- Indocyanine green (ICG) is strongly supported by current evidence as the tracer of choice for SLN mapping in endometrial and cervical cancers.
- While ICG is used in vulvar cancer, often with Tc-99m, its impact has been less transformative compared to its role in cervical and endometrial cancers.
Conclusions:
- ICG fluorescence imaging is now the preferred tracer for lymphatic mapping in the majority of gynecologic cancers.
- For early-stage vulvar cancer, sentinel lymph node biopsy using radioactive tracers remains the established standard for lymph node status assessment.
