Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands.
Mol Imaging Biol. 2011 Oct;13(5):1043-9. doi: 10.1007/s11307-010-0425-7.
Real-time intraoperative near-infrared fluorescence (NIRF) imaging is a promising technique for lymphatic mapping and sentinel lymph node (SLN) detection. The purpose of this technical feasibility pilot study was to evaluate the applicability of NIRF imaging with indocyanin green (ICG) for the detection of the SLN in cervical cancer.
In ten patients with early stage cervical cancer, a mixture of patent blue and ICG was injected into the cervix uteri during surgery. Real-time color and fluorescence videos and images were acquired using a custom-made multispectral fluorescence camera system.
Real-time fluorescence lymphatic mapping was observed in vivo in six patients; a total of nine SLNs were detected, of which one (11%) contained metastases. Ex vivo fluorescence imaging revealed the remaining fluorescent signal in 11 of 197 non-sentinel LNs (5%), of which one contained metastatic tumor tissue. None of the non-fluorescent LNs contained metastases.
We conclude that lymphatic mapping and detection of the SLN in cervical cancer using intraoperative NIRF imaging is technically feasible. However, the technique needs to be refined for full applicability in cervical cancer in terms of sensitivity and specificity.
实时术中近红外荧光（NIRF）成像技术是一种有前途的淋巴作图和前哨淋巴结（SLN）检测技术。本技术可行性初步研究的目的是评估吲哚菁绿（ICG）用于检测宫颈癌 SLN 的适用性。
在 10 例早期宫颈癌患者中，在手术期间将专利蓝和 ICG 混合物注入子宫颈。使用定制的多光谱荧光相机系统获取实时彩色和荧光视频和图像。
在 6 例患者中观察到实时荧光淋巴作图；共检测到 9 个 SLN，其中 1 个（11%）含有转移。离体荧光成像显示 197 个非前哨 LNs 中有 11 个（5%）仍有荧光信号，其中 1 个含有转移性肿瘤组织。无荧光 LNs 均未发生转移。
我们得出结论，使用术中 NIRF 成像进行宫颈癌的淋巴作图和 SLN 检测在技术上是可行的。然而，为了提高该技术在宫颈癌中的灵敏度和特异性，需要对其进行进一步改进。
