A Custom-Made, Low-Cost Intraoperative Fluorescence Navigation System with Indocyanine Green for Sentinel Lymph Node Biopsy in Skin Cancer

• Published in: Dermatology Vol. 222; no. 3; pp. 261 - 268
• Main Authors: Fujisawa, Yasuhiro, Nakamura, Yasuhiro, Kawachi, Yasuhiro, Otsuka, Fujio
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.06.2011; S. Karger AG
• Subjects: Adenocarcinoma - pathology; Axilla; Biological and medical sciences; Carcinoma, Squamous Cell - pathology; Dermatology; Equipment Design - economics; Fluorescence; Humans; Indocyanine Green; Luminescent Measurements; Lymphatic system; Medical sciences; Melanoma - pathology; Miscellaneous; Navigation systems; Neck; Original Paper; Paget Disease, Extramammary - pathology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sentinel Lymph Node Biopsy - methods; Skin cancer; Skin Neoplasms - pathology; Tumors of the skin and soft tissue. Premalignant lesions; Fluorescence; Indocyanine green; Sentinel lymph node biopsy; Skin cancer; Skin disease; Costs; Dermatology; Sentinel lymph node; Intraoperative; Malignant tumor; Biopsy; Health economy; Public health; Cancer
• ISSN: 1018-8665; 1421-9832; 1421-9832
• DOI: 10.1159/000327080

Background: Recently, indocyanine green (ICG) fluorescence imaging has been reported as new method to detect sentinel lymph nodes (SLNs). However, high introduction costs limit its use. Objective: The purpose of this study was to test an ICG fluorescence detection system constructed with parts commonly available on the market and to compare the SLN detection rate with that of the conventional combined dye and RI methods. Methods: We constructed this system using a charge-coupled device camera and light-emitting diodes. Results: We could construct our system at a cost of less than USD 1,600. This system could trace lymphatic channels through the skin and detect SLNs in 16 patients with skin cancer. However, SLNs in the neck were difficult to detect through the skin. Conclusion: Our system could be assembled at a reasonable cost and allowed us to detect SLNs efficiently. It may be used as an alternative to radiotracer for detecting SLNs located in the groin and axillary regions.