Examining the potential of preoperative CT lymphography with ICG in oral cancer
Source: www.cancernetwork.com Author: Leah Lawrence The majority of patients with localized squamous cell carcinoma of the tongue had at least one sentinel lymph node (SLN) successfully identified and removed using preoperative computed tomography (CT) lymphography and intraoperative indocyanine green (ICG) fluorescence, according to a small study published in JAMA Otolaryngology-Head & Neck Surgery. According to Kohei Honda, MD, of Hiigata University Graduate School of Medical and Dental Sciences, in Akita, Japan, and colleagues, this combined method “has the potential to provide clear visualization with high sensitivity, even if the SLN is located close to the primary injection site”. Traditionally, SLN detection is performed using preoperative lymphoscintigraphy with radioisotopes and intraoperative γ-probe detection with or without blue dye mapping. However, the use of radioisotopes has its disadvantages, including exposure to radiation, high cost, and masking of SLN because of shine-through radioactivity when close to the injection site. Honda and colleagues tested the usefulness of SLN biopsy with preoperative CT lymphography and intraoperative ICG. The study included 18 patients with previously untreated cN0 tongue cancer. All patients underwent CT lymphography prior to SLN biopsy. During biopsy, a minimum skin incision was made according to a predetermined location of SLN and SLN were excised under ICG guidance. Of the 18 patients, SLN could be mapped using preoperative CT lymphography in 16 patients (89%), in whom at least one SLN was identified and removed using intraoperative ICG. Metastases to SLN were found in 5 of the 16 patients (31%). There were two patients with [...]