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Surgical Oncology

  • Sentinel node biopsy is a surgical procedure used in Surgical Oncology to determine whether cancer has spread beyond the primary tumor. The sentinel nodes are the first few lymph nodes into which a tumor drains.

  • Sentinel Lymph Node Biopsy (SLNB) has been proven to improve outcomes for patients with early breast cancer, by avoiding unnecessary axillary lymph node dissections.

  • The standard method so far to detect the sentinel lymph node

  • Uses injection of Technetium-99m, a radioisotope, and a gamma probe for detection (no visualization).
  • To visualize the node, a staining agent like blue dye is employed. Blue dye is known to cause tattooing of the skin.
  • Indocyanine green (ICG) Fluorescence imaging for SLNB has the same detection rate as Technetium-99m and Blue dye combined. It also provides intraoperative visualization.

  • ICG Fluorescence imaging provides real-time visualization of lymphatic channels and nodes without any harmful radiation. Unlike technetium-99m which has to be handled by radiation medicine personnel, ICG can be used by surgeons themselves.

  • .nm Fluorescence Imaging system is designed to empower surgeons in surgical oncology to independently perform the entire operation beginning from preparation of contrast agent to identifications and removal of sentinel nodes.

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Surgical Oncology References

A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer

Wishart, G.C. et al.

European Journal of Surgical Oncology , Volume 38 , Issue 8 , 651 – 656

https://www.ejso.com/article/S0748-7983(12)00327-7/fulltext

Evolution in sentinel lymph node biopsy in breast cancer

Qiu, Si-Qi et al.

Critical Reviews in Oncology / Hematology , Volume 123 , 83 – 94

https://www.croh-online.com/article/S1040-8428(17)30035-5/fulltext
Liu J, Huang L, Wang N, Chen P. Indocyanine green detects sentinel lymph nodes in early breast cancer.

J Int Med Res. 2017;45(2):514-524.

http://journals.sagepub.com/doi/10.1177/0300060516687149
Randomized Comparison of Near-infrared Fluorescence Imaging Using Indocyanine Green and 99m Technetium With or Without Patent Blue for the Sentinel Lymph Node Procedure in Breast Cancer Patients

Ann Surg Oncol. 2012;19(13):4104-11.

https://link.springer.com/article/10.1245%2Fs10434-012-2466-4
Schaafsma BE, Verbeek FP, Peters AA, et al. Near-infrared fluorescence sentinel lymph node biopsy in vulvar cancer: a randomised comparison of lymphatic tracers

BJOG. 2013;120(6):758-64.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3622799/
Peng H, Wang SJ, Niu X, Yang X, Chi C, Zhang G. Sentinel node biopsy using indocyanine green in oral/oropharyngeal cancer.

World J Surg Oncol. 2015;13:278.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4574454/
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