Endoscopic sentinel lymph node biopsy using indocyanine green-neomannosyl human serum albumin

Young Min Park, Yu Hua Quan, Ki Hyeok Kwon, Jae Gu Cho, Jeong Soo Woo, Beop Min Kim, Yun Sang Lee, Jae Min Jeong, Hyun Koo Kim, Jae Jun Song

    Research output: Contribution to journalArticlepeer-review

    6 Citations (Scopus)

    Abstract

    Objective: The aim of this study was to determine the possibility of endoscopic sentinel lymph node biopsy of the head and neck region using indocyanine green-neomannosyl human serum albumin (ICG:MSA) and a custom-made intraoperative color-and-fluorescence-merged imaging system (ICFIS). Methods: Using mouse and rabbit models of tongue cancer, we performed sentinel lymph node biopsy using an ICG:MSA tracer and custom imaging system equipped with an endoscope. Results: ICG:MSA was localized to the cervical lymph node on the ipsilateral side for up to 30 minutes compared to ICG tracer (ICG n = 3, IGC:MSA n = 3). Detection of sentinel lymph nodes was attempted after injecting ICG:MSA in the mouse tongue cancer model (n = 3). During the operation, lymph nodes were easily identified and resected using ICFIS without the aid of other magnifiers. In the rabbit tongue cancer model (n = 3), the ICFIS equipped with 30-degree endoscopy was used to confirm the feasibility of endoscopic sentinel lymph node biopsy. The entire sentinel lymph node biopsy procedure was performed using the ICFIS with the 30-degree endoscope. We detected and dissected sentinel lymph nodes in the rabbit model without the other sentinel lymph node detection tools. Conclusion: We confirmed the usefulness of sentinel lymph node biopsy using a near infrared fluorescence technique and endoscopic system. Avoidance of radiation exposure and shine-through phenomena, which are problems of sentinel lymph node biopsy using conventional radioisotopes, are advantages of our surgical technique. By combining the endoscopic system with a sentinel lymph node biopsy procedure, we avoided visible neck scars, which lead to excellent cosmetic outcomes. Level of Evidence: NA. Laryngoscope, 128:E135–E140, 2018.

    Original languageEnglish
    Pages (from-to)E135-E140
    JournalLaryngoscope
    Volume128
    Issue number4
    DOIs
    Publication statusPublished - 2018 Apr

    Bibliographical note

    Funding Information:
    This study was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI13C1501). The authors have no other funding, financial relationships, or conflicts of interest to disclose.

    Funding Information:
    From the Department of Otorhinolaryngology–Head and Neck Surgery (Y.M.P., J-G.C., J-S.W., J-J.S.); the Department of Thoracic and Cardiovascular Surgery (Y.H.Q., H.K.K.), Korea University College of Medicine; the Department of Biomedical Sciences, College of Medicine, Korea University (Y.H.Q., H.K.K.); the Department of Interdisciplinary Bio/Micro System Technology, Korea University College of Engineering (K.H.K., B-M.K.); the Department of Bio-convergence Engineering, School of Biomedical Engineering, Korea University College of Health Science (B-M.K.); and the Department of Nuclear Medicine, College of Medicine, Seoul National University (Y-S.L., J.M.J.), Seoul, Republic of Korea Editor’s Note: This Manuscript was accepted for publication on November 8, 2017.

    Publisher Copyright:
    © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

    Keywords

    • Sentinel lymph node
    • endoscopic system
    • indocyanine green

    ASJC Scopus subject areas

    • Otorhinolaryngology

    Fingerprint

    Dive into the research topics of 'Endoscopic sentinel lymph node biopsy using indocyanine green-neomannosyl human serum albumin'. Together they form a unique fingerprint.

    Cite this