Sentinel lymph node mapping using ICG fluorescence and cone beam CT - a feasibility study in a rabbit model of oral cancer

Nidal Muhanna, Harley H.L. Chan, Catriona M. Douglas*, Michael J. Daly, Atul Jaidka, Donovan Eu, Jonathan Bernstein, Jason L. Townson, Jonathan C. Irish

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Current sentinel lymph node biopsy (SLNB) techniques, including use of radioisotopes, have disadvantages including the use of a radioactive tracer. Indocyanine green (ICG) based near-infrared (NIR) fluorescence imaging and cone beam CT (CBCT) have advantages for intraoperative use. However, limited literature exists regarding their use in head and neck cancer SLNB. Methods: This was a prospective, non-randomized study using a rabbit oral cavity VX2 squamous cell carcinoma model (n = 10) which develops lymph node metastasis. Pre-operatively, images were acquired by MicroCT. During surgery, CBCT and NIR fluorescence imaging of ICG was used to map and guide the SLNB resection. Results: Intraoperative use of ICG to guide fluorescence resection resulted in identification of all lymph nodes identified by pre-operative CT. CBCT was useful for near real time intraoperative imaging and 3D reconstruction. Conclusions: This pre-clinical study further demonstrates the technical feasibility, limitations and advantages of intraoperative NIR-guided ICG imaging for SLN identification as a complementary method during head and neck surgery.

Original languageEnglish
Article number106
JournalBMC Medical Imaging
Volume20
Issue number1
DOIs
StatePublished - 14 Sep 2020

Keywords

  • Cone beam CT
  • Head and neck cancer
  • Head and neck surgery
  • Indocyanine green
  • Near-infrared fluorescence imaging
  • Sentinel lymph node biopsy

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