Indocyanine green fluorescence-guided sentinel lymph node biopsy: A systematic review

Area of Science:

• Oncology
• Surgical Innovation
• Medical Imaging

Background:

• Accurate staging of cervical lymph nodes is critical for head and neck cancer (HNC) management.
• Sentinel lymph node biopsy (SLNB) is a less invasive alternative to neck dissection for detecting metastases.
• Indocyanine green (ICG) fluorescence guidance offers a novel approach to SLNB.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of ICG fluorescence-guided SLNB in HNC.
• To compare ICG-guided SLNB with traditional methods for sentinel lymph node identification.

Main Methods:

• A systematic literature review of PubMed, Embase, and Scopus databases was performed.
• Six clinical studies involving 86 head and neck tumors met the inclusion criteria.
• Data on patient characteristics, imaging, and detection rates were extracted; risk of bias was assessed using MINORS criteria.

Main Results:

• ICG fluorescence imaging demonstrated a higher pooled SLN detection rate (98.0%) than gamma tracing (87.6%).
• Pooled sensitivity for fluorescence imaging (71.0%) surpassed gamma tracing (66.7%), with 100% specificity for both.
• The average quality of included studies was moderate.

Conclusions:

• ICG-guided SLNB is a feasible and effective technique for HNC.
• This method shows potential for improved clinical and oncologic outcomes over standard lymphoscintigraphy.
• Further research with standardized metrics is necessary to confirm findings and optimize techniques.