Optimal settings of near-infrared fluorescence imaging with indocyanine green for intraoperative detection of lymph node metastasis in esophageal cancer

Gen Thorac Cardiovasc Surg. 2022 Oct;70(10):924-929. doi: 10.1007/s11748-022-01859-7. Epub 2022 Aug 11.

Abstract

Lymphatic flow mapping using near-infrared fluorescence (NIR) imaging with indocyanine green (ICG) has been used for intraoperative diagnosis of lymph node metastasis (LNM) in various cancers. Accurate prediction of LNM intraoperatively may allow minimization of the extent of lymphadenectomy. However, a consistent method and diagnostic ability, allowing application of NIR-guided lymphatic flow mapping to esophageal cancer (EC), have not been established due to the multidirectional and complex characteristics of lymphatic flow in the esophagus. Herein, we present a novel NIR-guided surgical technique for predicting lymph node stations potentially containing LNM in EC with high diagnostic accuracy derived from appropriately adjusting the ICG injection setting.

Keywords: Esophageal cancer; Indocyanine green; Lymph node metastasis; Near-infrared fluorescence image.

MeSH terms

  • Esophageal Neoplasms* / diagnostic imaging
  • Esophageal Neoplasms* / pathology
  • Esophageal Neoplasms* / surgery
  • Humans
  • Indocyanine Green*
  • Lymph Node Excision / methods
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / pathology
  • Optical Imaging / methods
  • Sentinel Lymph Node Biopsy / methods

Substances

  • Indocyanine Green