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Near-infrared fluorescence sentinel lymph node mapping of the oral cavity in head and neck cancer patients.
Oral Oncol. 2013 Jan; 49(1):15-9.OO

Abstract

OBJECTIVES

Elective neck dissection is frequently performed during surgery in head and neck cancer patients. The sentinel lymph node (SLN) procedure can prevent the morbidity of a neck dissection and improve lymph node staging by fine pathology. Near-infrared (NIR) fluorescence imaging is a promising technique to identify the sentinel lymph node (SLN) intraoperatively. This feasibility study explored the use of indocyanine green adsorbed to human serum albumin (ICG:HSA) for SLN mapping in head and neck cancer patients.

MATERIALS AND METHODS

A total of 10 consecutive patients with oral cavity or oropharyngeal cancer and a clinical N0 neck were included. After exposure of the neck, 1.6 mL of ICG:HSA (500 μM) was injected at four quadrants around the tumor. During the neck dissection, levels I-IV were measured for fluorescence using the Mini-FLARE imaging system.

RESULTS

In all 10 patients, NIR fluorescence imaging enabled visualization of one or more SLNs. A total of 17 SLNs were identified. The mean contrast between the fluorescent signal of the lymph nodes and of the surrounding tissue was 8.7±6.4. In 3 patients, of which 1 was false-negative, lymph node metastases were found. After administration of ICG:HSA, the average number of fluorescent lymph nodes significantly increased over time (P<0.001).

CONCLUSION

This study demonstrated feasibility to detect draining lymph nodes in head and neck cancer patients using NIR fluorescence imaging. However, the fluorescent tracer quickly migrated beyond the SLN to higher tier nodes.

Authors+Show Affiliations

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22939692

Citation

van der Vorst, Joost R., et al. "Near-infrared Fluorescence Sentinel Lymph Node Mapping of the Oral Cavity in Head and Neck Cancer Patients." Oral Oncology, vol. 49, no. 1, 2013, pp. 15-9.
van der Vorst JR, Schaafsma BE, Verbeek FP, et al. Near-infrared fluorescence sentinel lymph node mapping of the oral cavity in head and neck cancer patients. Oral Oncol. 2013;49(1):15-9.
van der Vorst, J. R., Schaafsma, B. E., Verbeek, F. P., Keereweer, S., Jansen, J. C., van der Velden, L. A., Langeveld, A. P., Hutteman, M., Löwik, C. W., van de Velde, C. J., Frangioni, J. V., & Vahrmeijer, A. L. (2013). Near-infrared fluorescence sentinel lymph node mapping of the oral cavity in head and neck cancer patients. Oral Oncology, 49(1), 15-9. https://doi.org/10.1016/j.oraloncology.2012.07.017
van der Vorst JR, et al. Near-infrared Fluorescence Sentinel Lymph Node Mapping of the Oral Cavity in Head and Neck Cancer Patients. Oral Oncol. 2013;49(1):15-9. PubMed PMID: 22939692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Near-infrared fluorescence sentinel lymph node mapping of the oral cavity in head and neck cancer patients. AU - van der Vorst,Joost R, AU - Schaafsma,Boudewijn E, AU - Verbeek,Floris P R, AU - Keereweer,Stijn, AU - Jansen,Jeroen C, AU - van der Velden,Lilly-Ann, AU - Langeveld,Antonius P M, AU - Hutteman,Merlijn, AU - Löwik,Clemens W G M, AU - van de Velde,Cornelis J H, AU - Frangioni,John V, AU - Vahrmeijer,Alexander L, Y1 - 2012/08/28/ PY - 2012/03/06/received PY - 2012/05/10/revised PY - 2012/07/26/accepted PY - 2012/9/4/entrez PY - 2012/9/4/pubmed PY - 2013/6/1/medline SP - 15 EP - 9 JF - Oral oncology JO - Oral Oncol. VL - 49 IS - 1 N2 - OBJECTIVES: Elective neck dissection is frequently performed during surgery in head and neck cancer patients. The sentinel lymph node (SLN) procedure can prevent the morbidity of a neck dissection and improve lymph node staging by fine pathology. Near-infrared (NIR) fluorescence imaging is a promising technique to identify the sentinel lymph node (SLN) intraoperatively. This feasibility study explored the use of indocyanine green adsorbed to human serum albumin (ICG:HSA) for SLN mapping in head and neck cancer patients. MATERIALS AND METHODS: A total of 10 consecutive patients with oral cavity or oropharyngeal cancer and a clinical N0 neck were included. After exposure of the neck, 1.6 mL of ICG:HSA (500 μM) was injected at four quadrants around the tumor. During the neck dissection, levels I-IV were measured for fluorescence using the Mini-FLARE imaging system. RESULTS: In all 10 patients, NIR fluorescence imaging enabled visualization of one or more SLNs. A total of 17 SLNs were identified. The mean contrast between the fluorescent signal of the lymph nodes and of the surrounding tissue was 8.7±6.4. In 3 patients, of which 1 was false-negative, lymph node metastases were found. After administration of ICG:HSA, the average number of fluorescent lymph nodes significantly increased over time (P<0.001). CONCLUSION: This study demonstrated feasibility to detect draining lymph nodes in head and neck cancer patients using NIR fluorescence imaging. However, the fluorescent tracer quickly migrated beyond the SLN to higher tier nodes. SN - 1879-0593 UR - https://www.unboundmedicine.com/medline/citation/22939692/Near_infrared_fluorescence_sentinel_lymph_node_mapping_of_the_oral_cavity_in_head_and_neck_cancer_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1368-8375(12)00245-X DB - PRIME DP - Unbound Medicine ER -