Fluorescence Guidance Reduces Operative Time for Sentinel Lymph Node Biopsy in the Head and Neck

Area of Science:

• Surgical Oncology
• Medical Imaging
• Biotechnology

Background:

• Sentinel lymph node biopsy (SLNB) is crucial for staging oral cancers.
• Current SLNB methods often rely on gamma probes, which can be time-consuming.
• Fluorescently labeled tracers offer potential for improved visualization and efficiency.

Purpose of the Study:

• To evaluate the added value of fluorescently labeled tilmanocept in oral cavity SLNB.
• To compare the efficacy of fluorescence-guided SLNB with gamma probe-guided SLNB.
• To assess the impact on operative time and accuracy of sentinel lymph node identification.

Main Methods:

• New Zealand white rabbits underwent oral cavity injections of radioactive and fluorescently labeled tilmanocept.
• Sentinel lymph node biopsies were performed using either fluorescence guidance or gamma probe guidance.
• Operative duration and accuracy of sentinel lymph node identification were measured and compared.

Main Results:

• Fluorescence guidance reduced SLN removal time by 1.8-fold (median 104s vs. 191s).
• Fluorescence-guided SLNB had a lower rate of non-sentinel node tissue removal (7.1% vs. 28.6%).
• Fluorescence signal durability was observed up to 5 days, with clear visualization using commercial imagers.

Conclusions:

• Fluorescently labeled tilmanocept enhances SLNB efficiency in the oral cavity.
• This method decreases operative time and reduces the removal of non-sentinel lymph node tissue.
• Fluorescence guidance represents a promising advancement for SLNB procedures.