Document Detail

Dose optimization for near-infrared fluorescence sentinel lymph node mapping in patients with melanoma.
MedLine Citation:
PMID:  23078649     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Regional lymph node involvement is the most important prognostic factor in cutaneous melanoma. As only 20% of patients with melanoma have occult nodal disease and would benefit from a regional lymphadenectomy, the sentinel lymph node (SLN) biopsy was introduced. Near-infrared (NIR) fluorescence has been hypothesized to improve SLN mapping.
OBJECTIVES:   To assess the potential of intraoperative NIR fluorescence imaging to improve SLN mapping in patients with melanoma and to examine the optimal dose of indocyanine green adsorbed to human serum albumin (ICG:HSA).
METHODS:   Fifteen consecutive patients with cutaneous melanoma underwent the standard SLN procedure using (99m) technetium-nancolloid and patent blue. In addition, intraoperative NIR fluorescence imaging was performed after injection of 1·6 mL of 600, 800, 1000 or 1200 μmolL(-1) of ICG: HSA in four quadrants around the primary excision scar.
RESULTS:   NIR fluorescence SLN mapping was successful in 93% of patients. In one patient, no SLN could be identified using either conventional methods or NIR fluorescence. A total of 30 SLNs (average 2·0, range 1-7) were detected, 30 radioactive (100%), 27 blue (73%) and 30 NIR fluorescent (100%). With regard to the effect of concentration on signal-to-background ratios a trend (P=0·066) was found favouring the 600, 800 and 1000 μmol L(-1) groups over the 1200 μmol L(-1) group.
CONCLUSION:  This study demonstrates feasibility and accuracy of SLN mapping using ICG: HSA. Considering safety, cost and pharmacological characteristics, an ICG: HSA concentration of 600 μmolL(-1) appears optimal for SLN mapping in cutaneous melanoma, although lower doses need to be assessed.
J R van der Vorst; B E Schaafsma; F P R Verbeek; R J Swijnenburg; M Hutteman; G J Liefers; C J H van de Velde; J V Frangioni; A L Vahrmeijer
Related Documents :
9583889 - Clinicopathologic significance of transitional cell carcinoma pattern in nonlocalized o...
679129 - The staging and treatment of epithelial ovarian cancer.
8221569 - National survey of ovarian carcinoma. vi. critical assessment of current international ...
21178999 - Neoadjuvant radiotherapy for locally advanced and high-risk prostate cancer.
21338719 - Adjuvant chemoradiotherapy in pancreatic adenocarcinoma-are we forcing a milestone?
19530239 - Low drug resistance to both platinum and taxane chemotherapy on an in vitro drug resist...
2525469 - Endocrine and immune effects of melatonin therapy in metastatic cancer patients.
10225559 - The modelled benefits of individualizing radiotherapy patients' dose using cellular rad...
9524709 - Impact on survival by method of recurrence detection in stage i and ii cutaneous melanoma.
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of dermatology     Volume:  168     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-02     Completed Date:  2013-06-07     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  93-8     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. BJD © 2012 British Association of Dermatologists.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Coloring Agents / diagnostic use
Dose-Response Relationship, Radiation
Feasibility Studies
Indocyanine Green / diagnostic use
Intraoperative Care / methods
Lymph Node Excision / methods
Lymph Nodes / pathology*
Lymphatic Metastasis
Melanoma / pathology*,  surgery
Middle Aged
Sentinel Lymph Node Biopsy / methods
Serum Albumin / radiation effects
Skin Neoplasms / pathology*,  surgery
Spectroscopy, Near-Infrared / methods
Young Adult
Grant Support
R01 CA115296/CA/NCI NIH HHS; R01-CA-115296/CA/NCI NIH HHS; R21 CA130297/CA/NCI NIH HHS; R21-CA-130297/CA/NCI NIH HHS
Reg. No./Substance:
0/Coloring Agents; 0/Serum Albumin; IX6J1063HV/Indocyanine Green

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Acute Poisoning with Neonicotinoid Insecticides: A Case Report and Literature Review.
Next Document:  Item and response-category functioning of the Persian version of the KIDSCREEN-27: Rasch partial cre...