A Comparison of Dye Versus Fluorescence Methods for Sentinel Lymph Node Mapping in Endometrial Cancer

Wataru Yamagami, Nobuyuki Susumu, Fumio Kataoka, Takeshi Makabe, Kensuke Sakai, Tomomi Ninomiya, Michiko Wada, Hiroyuki Nomura, Akira Hirasawa, Kouji Banno, Tadaki Nakahara, Kaori Kameyama, Daisuke Aoki

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

OBJECTIVE: Sentinel nodes (SNs) have been observed in several reports from Japan and overseas in cases with endometrial cancer; however, no consensus has been reached regarding the types of tracers or the method of their injection. A combination of the radioisotope (RI) and dye method is considered to be desirable. We assessed SN mapping using either dye or near-infrared fluorescence imaging to clarify a suitable method in cases of endometrial cancer.

METHODS: Patients were enrolled from 92 patients diagnosed with endometrial cancer and having no extrauterine metastasis by the preoperative imaging between 2009 and 2014 at our institution. To identify the SNs, we performed 3 methods using either dye or fluorescence solutions in conjunction with a RI method. In the dye method, we injected indocyanine green in the uterine subserosa, visually identifying SNs as stained green. In the fluorescence method, a dilute indocyanine green solution (0.5 mg, fluorescence A or 0.25 mg, fluorescence B, each per 10 mL of solvent) was injected and the SN identified by the HyperEye Medical System.

RESULTS: The SN detection rates were 100%, 100%, and 96% using dye and fluorescence A or B solution, respectively. Pelvic SNs were detected by the 3 methods in 98%, 100%, and 96% of cases and para-aortic SNs in 65%, 88%, and 74%, respectively. Fluorescence A solution was somewhat better than dye in detecting para-aortic SNs, although not significantly so (P = 0.07). The sensitivity and negative predictive values for detecting SNs with metastases with the dye method were 92% and 98% compared with 100% and 100%, respectively, for both fluorescence solutions.

CONCLUSIONS: Although both dye and fluorescence methods performed well, no method perfectly identified para-aortic SNs. The concomitant use of the RI method is required to detect para-aortic SNs.

Original languageEnglish
Pages (from-to)1517-1524
Number of pages8
JournalInternational journal of gynecological cancer : official journal of the International Gynecological Cancer Society
Volume27
Issue number7
DOIs
Publication statusPublished - 2017 Sep 1

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Endometrial Neoplasms
Coloring Agents
Fluorescence
Radioisotopes
Indocyanine Green
cyhalothrin
Sentinel Lymph Node
Neoplasm Metastasis
Optical Imaging
Japan

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynaecology

Cite this

A Comparison of Dye Versus Fluorescence Methods for Sentinel Lymph Node Mapping in Endometrial Cancer. / Yamagami, Wataru; Susumu, Nobuyuki; Kataoka, Fumio; Makabe, Takeshi; Sakai, Kensuke; Ninomiya, Tomomi; Wada, Michiko; Nomura, Hiroyuki; Hirasawa, Akira; Banno, Kouji; Nakahara, Tadaki; Kameyama, Kaori; Aoki, Daisuke.

In: International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, Vol. 27, No. 7, 01.09.2017, p. 1517-1524.

Research output: Contribution to journalArticle

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title = "A Comparison of Dye Versus Fluorescence Methods for Sentinel Lymph Node Mapping in Endometrial Cancer",
abstract = "OBJECTIVE: Sentinel nodes (SNs) have been observed in several reports from Japan and overseas in cases with endometrial cancer; however, no consensus has been reached regarding the types of tracers or the method of their injection. A combination of the radioisotope (RI) and dye method is considered to be desirable. We assessed SN mapping using either dye or near-infrared fluorescence imaging to clarify a suitable method in cases of endometrial cancer.METHODS: Patients were enrolled from 92 patients diagnosed with endometrial cancer and having no extrauterine metastasis by the preoperative imaging between 2009 and 2014 at our institution. To identify the SNs, we performed 3 methods using either dye or fluorescence solutions in conjunction with a RI method. In the dye method, we injected indocyanine green in the uterine subserosa, visually identifying SNs as stained green. In the fluorescence method, a dilute indocyanine green solution (0.5 mg, fluorescence A or 0.25 mg, fluorescence B, each per 10 mL of solvent) was injected and the SN identified by the HyperEye Medical System.RESULTS: The SN detection rates were 100{\%}, 100{\%}, and 96{\%} using dye and fluorescence A or B solution, respectively. Pelvic SNs were detected by the 3 methods in 98{\%}, 100{\%}, and 96{\%} of cases and para-aortic SNs in 65{\%}, 88{\%}, and 74{\%}, respectively. Fluorescence A solution was somewhat better than dye in detecting para-aortic SNs, although not significantly so (P = 0.07). The sensitivity and negative predictive values for detecting SNs with metastases with the dye method were 92{\%} and 98{\%} compared with 100{\%} and 100{\%}, respectively, for both fluorescence solutions.CONCLUSIONS: Although both dye and fluorescence methods performed well, no method perfectly identified para-aortic SNs. The concomitant use of the RI method is required to detect para-aortic SNs.",
author = "Wataru Yamagami and Nobuyuki Susumu and Fumio Kataoka and Takeshi Makabe and Kensuke Sakai and Tomomi Ninomiya and Michiko Wada and Hiroyuki Nomura and Akira Hirasawa and Kouji Banno and Tadaki Nakahara and Kaori Kameyama and Daisuke Aoki",
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T1 - A Comparison of Dye Versus Fluorescence Methods for Sentinel Lymph Node Mapping in Endometrial Cancer

AU - Yamagami, Wataru

AU - Susumu, Nobuyuki

AU - Kataoka, Fumio

AU - Makabe, Takeshi

AU - Sakai, Kensuke

AU - Ninomiya, Tomomi

AU - Wada, Michiko

AU - Nomura, Hiroyuki

AU - Hirasawa, Akira

AU - Banno, Kouji

AU - Nakahara, Tadaki

AU - Kameyama, Kaori

AU - Aoki, Daisuke

PY - 2017/9/1

Y1 - 2017/9/1

N2 - OBJECTIVE: Sentinel nodes (SNs) have been observed in several reports from Japan and overseas in cases with endometrial cancer; however, no consensus has been reached regarding the types of tracers or the method of their injection. A combination of the radioisotope (RI) and dye method is considered to be desirable. We assessed SN mapping using either dye or near-infrared fluorescence imaging to clarify a suitable method in cases of endometrial cancer.METHODS: Patients were enrolled from 92 patients diagnosed with endometrial cancer and having no extrauterine metastasis by the preoperative imaging between 2009 and 2014 at our institution. To identify the SNs, we performed 3 methods using either dye or fluorescence solutions in conjunction with a RI method. In the dye method, we injected indocyanine green in the uterine subserosa, visually identifying SNs as stained green. In the fluorescence method, a dilute indocyanine green solution (0.5 mg, fluorescence A or 0.25 mg, fluorescence B, each per 10 mL of solvent) was injected and the SN identified by the HyperEye Medical System.RESULTS: The SN detection rates were 100%, 100%, and 96% using dye and fluorescence A or B solution, respectively. Pelvic SNs were detected by the 3 methods in 98%, 100%, and 96% of cases and para-aortic SNs in 65%, 88%, and 74%, respectively. Fluorescence A solution was somewhat better than dye in detecting para-aortic SNs, although not significantly so (P = 0.07). The sensitivity and negative predictive values for detecting SNs with metastases with the dye method were 92% and 98% compared with 100% and 100%, respectively, for both fluorescence solutions.CONCLUSIONS: Although both dye and fluorescence methods performed well, no method perfectly identified para-aortic SNs. The concomitant use of the RI method is required to detect para-aortic SNs.

AB - OBJECTIVE: Sentinel nodes (SNs) have been observed in several reports from Japan and overseas in cases with endometrial cancer; however, no consensus has been reached regarding the types of tracers or the method of their injection. A combination of the radioisotope (RI) and dye method is considered to be desirable. We assessed SN mapping using either dye or near-infrared fluorescence imaging to clarify a suitable method in cases of endometrial cancer.METHODS: Patients were enrolled from 92 patients diagnosed with endometrial cancer and having no extrauterine metastasis by the preoperative imaging between 2009 and 2014 at our institution. To identify the SNs, we performed 3 methods using either dye or fluorescence solutions in conjunction with a RI method. In the dye method, we injected indocyanine green in the uterine subserosa, visually identifying SNs as stained green. In the fluorescence method, a dilute indocyanine green solution (0.5 mg, fluorescence A or 0.25 mg, fluorescence B, each per 10 mL of solvent) was injected and the SN identified by the HyperEye Medical System.RESULTS: The SN detection rates were 100%, 100%, and 96% using dye and fluorescence A or B solution, respectively. Pelvic SNs were detected by the 3 methods in 98%, 100%, and 96% of cases and para-aortic SNs in 65%, 88%, and 74%, respectively. Fluorescence A solution was somewhat better than dye in detecting para-aortic SNs, although not significantly so (P = 0.07). The sensitivity and negative predictive values for detecting SNs with metastases with the dye method were 92% and 98% compared with 100% and 100%, respectively, for both fluorescence solutions.CONCLUSIONS: Although both dye and fluorescence methods performed well, no method perfectly identified para-aortic SNs. The concomitant use of the RI method is required to detect para-aortic SNs.

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DO - 10.1097/IGC.0000000000000997

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