Real-Time Fluorescent Sentinel Lymph Node Mapping with Indocyanine Green in Women with Previous Conization Undergoing Laparoscopic Surgery for Early Invasive Cervical Cancer: Comparison with Radiotracer ± Blue Dye

3区 · 医学

Article

作者: Elena De Ponti ; Beatrice Bussi ; Giampaolo Di Martino ; Cinzia Crivellaro ; Maria Luisa Gasparri ; Andrea Papadia ; Sara Imboden ; Luca Guerra ; Michael Mueller ; Claudio Reato ; Alessandro Buda

STUDY OBJECTIVETo evaluate the added value of the fluorescence dye indocyanine green (ICG) for sentinel lymph node (SLN) mapping in women with cervical cancer who had undergone previous conization (stage 1A-1B1) by comparing ICG versus Tc99^m radiotracer + blue dye (BD).DESIGNRetrospective study (Canadian Task Force classification II-2).SETTINGTwo European academic medical centers, San Gerardo Hospital, Italy and University of Berne, Switzerland.PATIENTSSixty-five women with early stage (IA-IB1) cervical cancer who had undergone previous conization and who underwent SLN mapping with Tc99^m ± BD (n = 23) or ICG (n = 42) followed by pelvic lymphadenectomy and fertility-sparing surgery or hysterectomy were included in this analysis.INTERVENTIONOverall detection rate and bilateral SLN mapping rates of ICG were compared with those obtained using the standard Tc99^m radiocolloid and BD.MEASUREMENT AND MAIN RESULTSOverall, 220 SLNs were detected. The median number of SLNs per patient in the Tc99^m ± BD group was 2 (range, 1-5) and in the ICG group, 3 (range, 2-15). The detection rate of SLNs was 95.7% in Tc99^m ± BD group and 100% in the ICG group (p = .354). The women injected with ICG had a higher rate of bilateral mapping of the SLNs as compared with the Tc99^m ± BD group (95.2% vs 69.6%, p = .016%). Only 12% of the patients (8/65) presented metastatic nodes, 2 in the Tc99^m ± BD group and 6 in the ICG group.CONCLUSIONIn early-stage cervical cancer patients conization had no significant impact on the SLN detection rate using both techniques (ICG and radiotracer ± BD). In this scenario a higher bilateral mapping rate was confirmed using the fluorescent dye ICG rather than the standard techniques.

2017-09-01·Journal of Minimally Invasive Gynecology3区 · 医学

Indocyanine Green versus Radiotracer with or without Blue Dye for Sentinel Lymph Node Mapping in Stage >IB1 Cervical Cancer (>2 cm)

3区 · 医学

Article

作者: Buda, Alessandro ; Mueller, Michael ; Di Martino, Giampaolo ; Bussi, Beatrice ; Gasparri, Maria Luisa ; Crivellaro, Cinzia ; Papadia, Andrea ; Locatelli, Luca ; Vizza, Enrico ; Elisei, Federica ; De Ponti, Elena ; Zapardiel, Ignacio ; Di Lorenzo, Paolo ; Diestro, Maria Dolores

STUDY OBJECTIVETo compare sentinel lymph node (SLN) mapping in women with cervical cancer stage >IB1 (tumor size >2 cm) using indocyanine green (ICG) versus the standard technique using radioisotope technetium 99m radiocolloid (Tc99^m) radiotracer with or without blue dye.DESIGNEuropean multicenter, retrospective observational study (Canadian Task Force classification II-2).SETTINGFour academic medical centers.PATIENTSNinety-five women with stage IB1 cervical cancer (>2 cm) who underwent SLN mapping with Tc99^m with or without blue dye or ICG and radical hysterectomy.INTERVENTIONThe detection rate and bilateral mapping rate were compared between ICG and standard Tc99^m radiotracer with or without blue dye. Lymphadenectomy was performed, and the false-negative rate was assessed.MEASUREMENTS AND MAIN RESULTSForty-seven patients underwent SLN mapping with Tc99^m with or without blue dye, and 48 did so with ICG. All patients underwent radical hysterectomy with or without bilateral salpingo-oophorectomy between 2008 and 2016. The overall detection rate of SLN mapping was 91.5% for Tc99^m with or without blue dye and 100% for ICG. A 91.7% rate of bilateral migration was achieved for ICG, significantly higher than the 66% obtained with Tc99^m with or without blue dye (p = .025). Nine of the 23 SLN-positive patients (39.1%) were diagnosed exclusively as a result of the ultrastaging used to identify micrometastases or isolated tumor cells only.CONCLUSIONSIn advanced cervical cancer (stage IB1 >2 cm), the detection rate and bilateral migration rate on real-time fluorescent SLN mapping were higher with ICG than with Tc99^m radiotracer with or without blue dye. SLN mapping and ultrastaging can provide additional information for nodal staging in advanced cervical cancer. In this setting, ICG is a promising tool for mapping, appearing less affected by higher disease stage compared with traditional methods.

2017-03-01·Journal of Cancer Research and Clinical Oncology3区 · 医学

Sentinel lymph node mapping in patients with stage I endometrial carcinoma: a focus on bilateral mapping identification by comparing radiotracer Tc99m with blue dye versus indocyanine green fluorescent dye

3区 · 医学

Article

作者: Buda, Alessandro ; De Ponti, Elena ; Zapardiel, Ignacio ; Di Martino, Giampaolo ; Mueller, Michael ; Bussi, Beatrice ; Imboden, Sara ; Dell'Orto, Federica ; Ghezzi, Fabio ; de la Noval, Begoña Diaz ; Vecchione, Francesca ; De Santiago, Javier ; Ceccaroni, Marcello ; Gasparri, Maria Luisa ; Elisei, Federica ; Papadia, Andrea

PURPOSEThe aim of this study was to compare technetium radiocolloid (Tc99^m) + blue dye (BD) versus Indocyanine green (ICG) fluorescent dye in terms of the overall detection rate and bilateral sentinel lymph node (SLN) mapping in patients with endometrial carcinoma.METHODSPatients from five European centers with apparently confined clinical stage I endometrial cancer were reviewed. A comparison was made between women who received SLN mapping with pelvic and/or aortic lymphadenectomy (LND), and women who underwent SLN algorithm (SA), was also performed between the two groups.RESULTSThree hundred and forty-two (342) women were involved (147 in the Tc99^m + BD group and 195 in the ICG group). The overall detection rate of SLN biopsy was 97.3% (143/147) for women in the Tc99^m + BD group and 96.9% (189/195) for women in the ICG group (p = 0.547). The bilateral mapping rate for ICG was 84.1%-significantly higher with respect to the 73.5% obtained with Tc99^m + BD (p = 0.007). No differences in overall sensitivity (OS) and overall false negative rate (FNR) were seen between LND and SA (p value = 0.311), whereas the negative predictive value (NPV) was in favor of SA group (p value = 0.030).CONCLUSIONSIn this study, fluorescent mapping using ICG resulted equivalent to the standard combined radiocolloid and BD, but real-time SLN mapping achieves a higher bilateral detection rate. The added value that this fast emerging technology promises to give certainly warrants future studies to further consolidate the advantages there are over the standard technique.

100 项与锝[99mTc]聚合白蛋白相关的药物交易

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