Use of indocyanine green for detecting the sentinel lymph node in breast cancer patients: from preclinical evaluation to clinical validation.
Use of indocyanine green for detecting the sentinel lymph node in breast cancer patients: from preclinical evaluation to clinical validation.
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DOI：
10.1371/journal.pone.0083927
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Tian J
中科院分区：
文献类型：
--
作者：
Chi C;Ye J;Ding H;He D;Huang W;Zhang GJ;Tian J
早期乳腺癌患者前哨淋巴结（SLN）的评估对于选择合适的手术入路至关重要。然而，现有的亚甲基蓝、核素等方法对sln的定位效率和有效性较低，且在应用过程中存在一定的副作用。吲哚菁绿（ICG）作为一种荧光染料，已被证明可靠地用于SLN的检测。本文介绍了一种利用ICG检测SLN的外科导航系统。该系统包含两个电荷耦合器件（CCD），通过两个不同的波段同时捕获实时彩色和荧光视频图像。在手术过程中，外科医生只需要跟随荧光显示。此外，该系统在手术过程中自动保存数据，使外科医生能够根据图像识别算法轻松找到配准点。为了测试我们的系统，我们的实验以5只小鼠和10只兔子为临床前环境，22名乳腺癌患者为临床评估。22例患者平均发现2.7个sln，检出率为100%。我们的研究结果表明，使用我们的手术导航系统与ICG检测乳腺癌患者的sln在技术上是可行的。
Assessment of the sentinel lymph node (SLN) in patients with early stage breast cancer is vital in selecting the appropriate surgical approach. However, the existing methods, including methylene blue and nuclides, possess low efficiency and effectiveness in mapping SLNs, and to a certain extent exert side effects during application. Indocyanine green (ICG), as a fluorescent dye, has been proved reliable usage in SLN detection by several other groups. In this paper, we introduce a novel surgical navigation system to detect SLN with ICG. This system contains two charge-coupled devices (CCD) to simultaneously capture real-time color and fluorescent video images through two different bands. During surgery, surgeons only need to follow the fluorescence display. In addition, the system saves data automatically during surgery enabling surgeons to find the registration point easily according to image recognition algorithms. To test our system, 5 mice and 10 rabbits were used for the preclinical setting and 22 breast cancer patients were utilized for the clinical evaluation in our experiments. The detection rate was 100% and an average of 2.7 SLNs was found in 22 patients. Our results show that the usage of our surgical navigation system with ICG to detect SLNs in breast cancer patients is technically feasible.
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