Our Summary

This research paper is about the use of indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging to improve the detection of sentinel lymph nodes (SLNs) in melanoma patients. Currently, the process of detecting these nodes, which is key for melanoma treatment, has a high rate of failure. The researchers reviewed previous studies to assess how ICG and NIRF imaging has been used in practice. They found 13 studies that matched their criteria. The results indicated that ICG was successful in detecting between 86-100% of nodes that were also identified by another method called lymphoscintigraphy. On average, each patient had 2 nodes detected using ICG. The study concluded that ICG could be a useful addition to current detection methods, and it was found to be better than the traditional blue dye method. However, more comparative data is needed.

FAQs

  1. What is the role of sentinel lymph nodes in melanoma treatment?
  2. How does the use of indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging improve the detection of sentinel lymph nodes in melanoma patients?
  3. How does the effectiveness of ICG and NIRF imaging compare to traditional detection methods like the blue dye method and lymphoscintigraphy?

Doctor’s Tip

A doctor might tell a patient undergoing sentinel lymph node biopsy that using indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging can improve the detection of sentinel lymph nodes in melanoma patients. This method has been shown to be successful in detecting a high percentage of nodes and may be more effective than traditional methods. It is important to discuss this option with your doctor to determine if it is the best choice for your individual situation.

Suitable For

Patients who are typically recommended for sentinel lymph node biopsy include those with intermediate to high-risk melanoma, such as those with thick primary tumors, ulceration, or high mitotic rate. Additionally, patients with clinically negative lymph nodes but with a high risk of lymph node metastasis based on tumor characteristics may also be recommended for sentinel lymph node biopsy. Other factors that may influence the recommendation for this procedure include the patient’s age, overall health status, and preferences for treatment.

Timeline

Before Sentinel Lymph Node Biopsy:

  1. Patient is diagnosed with melanoma and recommended for sentinel lymph node biopsy.
  2. Patient undergoes pre-operative imaging studies to identify the location of the sentinel lymph node.
  3. Indocyanine green (ICG) is injected near the site of the tumor to help visualize the lymphatic system.
  4. Patient undergoes surgery to remove the sentinel lymph node.

After Sentinel Lymph Node Biopsy:

  1. The sentinel lymph node is examined for the presence of cancer cells.
  2. If cancer cells are found, further treatment options are discussed with the patient.
  3. If no cancer cells are found, the patient may not require further treatment.
  4. Patient undergoes regular follow-up appointments to monitor for any signs of recurrence or spread of melanoma.

What to Ask Your Doctor

  1. How does a sentinel lymph node biopsy work and why is it important for melanoma treatment?
  2. What are the benefits of using indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging for detecting sentinel lymph nodes?
  3. What is the success rate of ICG in detecting sentinel lymph nodes compared to other methods like lymphoscintigraphy?
  4. How many nodes on average are detected using ICG in melanoma patients?
  5. How does ICG compare to traditional methods like the blue dye method in terms of effectiveness?
  6. Are there any potential risks or side effects associated with using ICG for sentinel lymph node detection?
  7. How does the use of ICG and NIRF imaging impact the overall treatment plan for melanoma patients?
  8. Are there any ongoing studies or research that further support the use of ICG for detecting sentinel lymph nodes in melanoma patients?
  9. What are the limitations or challenges of using ICG and NIRF imaging for sentinel lymph node biopsy?
  10. How can I ensure that I am receiving the most accurate and up-to-date information about my sentinel lymph node biopsy procedure and the use of ICG?

Reference

Authors: Lafreniere AS, Shine JJ, Nicholas CR, Temple-Oberle CF. Journal: Eur J Surg Oncol. 2021 May;47(5):935-941. doi: 10.1016/j.ejso.2020.10.027. Epub 2020 Oct 24. PMID: 33121851