Cited 16 times since 2013 (1.3 per year) source: EuropePMC The Journal of surgical research, Volume 183, Issue 1, 25 4 2013, Pages 253-257 Ex vivo sentinel node mapping in colon cancer combining blue dye staining and fluorescence imaging. Schaafsma BE, Verbeek FP, van der Vorst JR, Hutteman M, Kuppen PJ, Frangioni JV, van de Velde CJ, Vahrmeijer AL
Background
The sentinel lymph node procedure has been proposed to improve nodal staging in colon cancer patients. The aim of this study was to assess the added value of near-infrared (NIR) fluorescence imaging to conventional blue dye staining for ex vivo sentinel lymph node mapping.
Materials and methods
We included 22 consecutive patients undergoing surgery for colon cancer. After tumor resection, we submucosally injected a premixed cocktail of the near-infrared lymphatic tracer HSA800 and blue dye around the tumor for detection of sentinel lymph nodes. We used the Mini-FLARE imaging system for fluorescence imaging.
Results
In 95% of patients, we identified at least one sentinel lymph node. Overall, a total of 77 sentinel lymph nodes were identified, 77 of which were fluorescent (100%) and 70 of which were blue (91%). Sentinel lymph nodes that were located deeper in the mesenteric fat could easily be located by NIR fluorescence. In four of five patients with lymph node metastases, tumor cells were present in at least one of the sentinel lymph nodes.
Conclusions
This study shows the successful use and added value of the NIR fluorescence tracer HSA800 to conventional blue dye for the ex vivo sentinel lymph node procedure in colon cancer.
