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Indocyanine Green Near-Infrared Fluorescence-Guided Sentinel Lymph Node Biopsy in Colon Cancer
Vlad Fagarasan1, Vasile V Bintintan1, Radu I Seicean1
11st Surgical Department, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania.
Biomedicines
|April 29, 2025
Summary
Near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) effectively maps lymphatic drainage and aids sentinel lymph node biopsy (SLNB) in colon cancer patients. This technique identifies atypical pathways, improving surgical decisions and patient outcomes.
Area of Science:
- Surgical Oncology
- Medical Imaging
- Pathology
Background:
- Indocyanine green (ICG)-guided near-infrared (NIR) fluorescence imaging offers potential for mapping lymphatic pathways.
- Sentinel lymph node biopsy (SLNB) is crucial for staging colon cancer.
Purpose of the Study:
- To evaluate the efficacy of ICG-guided NIR fluorescence in mapping lymphatic drainage.
- To assess its role in facilitating SLNB for colon cancer patients.
Main Methods:
- Prospective cohort study of 30 colon cancer patients.
- Peritumoral ICG injection for intraoperative sentinel lymph node (SLN) identification.
- Histopathological analysis (H&E and IHC) of excised SLNs.
Main Results:
- Successful SLN identification in 83.33% of cases.
- False positive rate of 6.6% and false negative rate of 8%.
- Atypical lymphatic drainage identified in 6.6% of patients, correlating with subsequent metastases.
Conclusions:
- NIR-ICG fluorescence is a safe, reliable method for SLNB in colon cancer.
- The technique can identify atypical lymphatic drainage, potentially guiding lymphadenectomy extent.
- ICG-guided imaging enhances surgical precision and staging accuracy.
