Real-time near-infrared fluorescence imaging mediated by blue dye in breast cancer patients

J Surg Oncol. 2020 May;121(6):964-966. doi: 10.1002/jso.25874. Epub 2020 Feb 26.

Abstract

Background: Near-infrared (NIR) fluorescence imaging has recently been introduced to the sentinel lymph node (SLN) mapping because of the benefits of the SLN biopsy, such as providing real-time and high-resolution optical guidance. Methylene blue is available and less expensive as an SLN mapping tracer. Our study aims to identify SLN through the NIR fluorescence imaging system mediated by blue dye.

Methods: Early-stage breast cancer patients were prospectively enrolled. All participants received a subareolar or peritumoral injection of 1 mL methylene blue (MB) before surgery. The MB fluorescence system was set immediately after injection. SLNs were searched and removed under the guidance of fluorescence and blue dye.

Results: We identified SLN adequately with the help of real-time lymphography and blue dye. Symbolic lymphatic drainage patterns were also observed.

Conclusion: NIR fluorescence imaging mediated by blue dye has benefits on the identification of lymph vessels, the location of SLN, and the patterns of breast lymphatic flow.

Keywords: breast cancer; methylene blue; near-infrared fluorescence; sentinel lymph node.

Publication types

  • Clinical Trial

MeSH terms

  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / pathology
  • Coloring Agents
  • Computer Systems
  • Female
  • Humans
  • Lymphography / methods
  • Methylene Blue*
  • Neoplasm Staging
  • Sentinel Lymph Node / diagnostic imaging*
  • Sentinel Lymph Node / pathology
  • Spectrometry, Fluorescence / methods
  • Spectroscopy, Near-Infrared / methods*

Substances

  • Coloring Agents
  • Methylene Blue