Identification of Metastatic Lymph Nodes Using Indocyanine Green Fluorescence Imaging

Kyungsu Kim, Kook Nam Han, Byeong Hyeon Choi, Jiyun Rho, Jun Hee Lee, Jae Seon Eo, Chungyeul Kim, Beop Min Kim, Ok Hwa Jeon, Hyun Koo Kim

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Indocyanine green (ICG) has been used to detect several types of tumors; however, its ability to detect metastatic lymph nodes (LNs) remains unclear. Our goal was to determine the feasibility of ICG in detecting metastatic LNs. We established a mouse model and evaluated the potential of ICG. The feasibility of detecting metastatic LNs was also evaluated in patients with lung or esophageal cancer, detected with computed tomography (CT) or positron-emission tomography (PET)/CT, and scheduled to undergo surgical resection. Tumors and metastatic LNs were successfully detected in the mice. In the clinical study, the efficacy of ICG was evaluated in 15 tumors and fifty-four LNs with suspected metastasis or anatomically key regional LNs. All 15 tumors were successfully detected. Among the fifty-four LNs, eleven were pathologically confirmed to have metastasis; all eleven were detected in ICG fluorescence imaging, with five in CT and seven in PET/CT. Furthermore, thirty-four LNs with no signals were pathologically confirmed as nonmetastatic. Intravenous injection of ICG may be a useful tool to detect metastatic LNs and tumors. However, ICG is not a targeting agent, and its relatively low fluorescence makes it difficult to use to detect tumors in vivo. Therefore, further studies are needed to develop contrast agents and devices that produce increased fluorescence signals.

Original languageEnglish
Article number1964
Issue number7
Publication statusPublished - 2023 Apr

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea and funded by the Ministry of Education, Science and Technology (NRF-2018R1D1A1B07048721) and The Korea Medical Device Development Fund grant funded by the Korean government (the Ministry of Science and ICT; Ministry of Trade, Industry and Energy; Ministry of Health and Welfare; and Ministry of Food and Drug Safety) (Project number: 1711138151, KMDF_PR_20200901_0094_02).

Publisher Copyright:
© 2023 by the authors.


  • fluorescence imaging
  • indocyanine green
  • metastatic lymph node
  • primary cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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