The use of indocyanine green and near-infrared fluorescence imaging to assist sentinel lymph node biopsy in cutaneous melanoma: A systematic review.

Publication date: May 01, 2021

Despite the use of blue dye and radioisotopes, sentinel lymph node biopsy (SLNB) is still associated with a high false-negative rate (FNR). The off-label use of indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging has been introduced with the objective of assisting SLNB and thereby improving regional control in melanoma. The objective of this study was to review and summarize the general experience, protocols and outcomes of the use of ICG and NIRF to assist SLNB in melanoma. A systematic literature review was performed in December 2019 as per the PRISMA guidelines. Inclusion criteria were articles written in English describing the applications of ICG in patients with melanoma. Systematic reviews, animal studies, case reports and letters to editors were excluded. Of the 585 studies retrieved, 13 articles met the inclusion criteria. The reported sentinel lymph node (SLN) detection rate using ICG was between 86 and 100% of nodes identified by lymphoscintigraphy. The average number of nodes per patient detected using ICG was 2. ICG fluorescence imaging contributed to the identification of 2. 0% of the total number of SLNs harvested. ICG fluorescence may be a useful adjunct to lymphoscintigraphy, although high-level comparative data is lacking. It was found to be superior to blue dye at detecting sentinel lymph nodes.

Concepts Keywords
Biopsy Infrared fluorescence imaging
December Medicine
Indocyanine Clinical medicine
Infrared Medical specialties
Optical imaging
Indocyanine green
Sentinel lymph node
Lymph node biopsy
Multispectral optoacoustic tomography
Fluorescence image-guided surgery


Type Source Name
drug DRUGBANK Methionine
pathway KEGG Melanoma
disease MESH melanoma
disease MESH biopsy

Original Article

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