Video-assisted thoracoscopic indocyanine green fluorescence imaging system shows sentinel lymph nodes in non-small-cell lung cancer.

Abstract

OBJECTIVE:

The primary objective was to assess the feasibility and accuracy of intraoperative sentinel lymph node mapping by using a video-assisted thoracoscopic indocyanine green fluorescence imaging system in patients with clinical stage I non-small-cell lung cancer.

METHODS:

Thirty-one patients who underwent operation between January 2009 and September 2009 were investigated for sentinel node biopsy. Indocyanine green fluorescence imaging was applied by an infrared light charge-coupled device, and sentinel nodes were identified intraoperatively and dissected. Histologic examination by hematoxylin-eosin staining was used to evaluate metastases.

RESULTS:

Sentinel lymph nodes were identified by segmentectomy in 11 of 14 patients (78.5%) and by lobectomy in 14 of 17 patients (82.4%). The total identification rate was 80.7% (25/31 patients), the false-negative rate was 0% (0/24 patients), and the overall accuracy rate was 80.7% (25/31 patients).

CONCLUSION:

Video-assisted thoracoscopic indocyanine green fluorescence image-guided surgery is feasible for sentinel node biopsy and may be a powerful tool to eliminate unnecessary lymph node dissection in patients with lung cancer.

• Authors: Shin-ichi Yamashita, Keita Tokuishi, Kentaro Anami, Michiyo Miyawaki, Toshihiko Moroga, Mirei Kamei, Shuji Suehiro, Kiyoshi Ono, Shinsuke Takeno, Masao Chujo, Satoshi Yamamoto, Katsunobu Kawahara
• Journal: The Journal of thoracic and cardiovascular surgery (J Thorac Cardiovasc Surg) Vol. 141 Issue 1 Pg. 141-4 (Jan 2011) ISSN: 1097-685X [Electronic] United States
• PMID: 20392454 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Chemical References

• Fluorescent Dyes
• Indocyanine Green

Topics

• Aged
• Aged, 80 and over
• Carcinoma, Non-Small-Cell Lung (pathology, surgery)
• False Negative Reactions
• Feasibility Studies
• Female
• Fluorescence
• Fluorescent Dyes
• Humans
• Indocyanine Green
• Japan
• Lung Neoplasms (pathology, surgery)
• Lymph Node Excision
• Lymphatic Metastasis
• Male
• Middle Aged
• Neoplasm Staging
• Pneumonectomy
• Predictive Value of Tests
• Sentinel Lymph Node Biopsy (methods)
• Thoracic Surgery, Video-Assisted