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Detection of Sentinel Node in Gastric Cancer Surgery by Indocyanine Green Fluorescence Imaging: Comparison with Infrared Imaging

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Secure methods for clinical detection of the sentinel node (SN) are in great demand to avoid unnecessary resection. This was a clinical exploration/feasibility study of a novel detection system for SN biopsy using indocyanine green (ICG) fluorescence imaging in gastric cancer surgery.

Methods

SN biopsy using ICG dye was performed in three patients who had gastric cancer. ICG fluorescence images were obtained using a detection system comprising a charge-coupled device (CCD) camera with a cut filter as the detector and light emitting diodes (LED) as the light source. The nodes were also examined simultaneously by an infrared (IR) imaging videoscope.

Results

Immediately after intraoperative ICG injection, the fluorescence imaging system allowed easy visualization of the lymphatic vessels draining from the primary gastric tumor toward the lymph nodes and tracing of the moving injected dye. Some lymph vessels and nodes were hardly recognized by ICG green color or IR imaging. The ICG fluorescence system also allowed visualization of the lymph node when ICG was injected the day before surgery, similar to the radio-guided method.

Conclusions

Detection of SNs in gastric cancer surgery using the ICG fluorescence imaging system is a promising novel technique and may perhaps prove useful for laparoscopic surgery.

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Acknowledgment

This study was supported in part by the Otsuka Grant.

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Authors and Affiliations

  1. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan

    Isao Miyashiro MD, Norikatsu Miyoshi MD, Kentaro Kishi MD, Terumasa Yamada MD, Masayuki Ohue MD, Hiroaki Ohigashi MD, Masahiko Yano MD, Osamu Ishikawa MD & Shingi Imaoka MD

  2. Department of Surgery, Itami Municipal Hospital, 1-100 Koyaike, Itami, Hyogo, 664-0015, Japan

    Masahiro Hiratsuka MD

Authors
  1. Isao Miyashiro MD
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  2. Norikatsu Miyoshi MD
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  3. Masahiro Hiratsuka MD
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  4. Kentaro Kishi MD
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  5. Terumasa Yamada MD
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  6. Masayuki Ohue MD
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  7. Hiroaki Ohigashi MD
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  8. Masahiko Yano MD
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  9. Osamu Ishikawa MD
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  10. Shingi Imaoka MD
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Corresponding author

Correspondence to Isao Miyashiro MD.

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Miyashiro, I., Miyoshi, N., Hiratsuka, M. et al. Detection of Sentinel Node in Gastric Cancer Surgery by Indocyanine Green Fluorescence Imaging: Comparison with Infrared Imaging. Ann Surg Oncol 15, 1640–1643 (2008). https://doi.org/10.1245/s10434-008-9872-7

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  • DOI: https://doi.org/10.1245/s10434-008-9872-7

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