Toward Optimization of Imaging System and Lymphatic Tracer for Near-Infrared Fluorescent Sentinel Lymph Node Mapping in Breast Cancer

• DOI: 10.1245/s10434-011-1566-x
• Publication Date: 2011-03-01T21:24:15Z
• Authors: J. Sven D. Mieog; Susan L. Troyan; Merlijn Hutteman; Kevin J. Donohoe; Joost R. van der ...; Alan Stockdale; Gerrit-Jan Liefers; Hak Soo Choi; Summer L. Gibbs-S...; Hein Putter; Sylvain Gioux; Peter J. K. Kuppen; Yoshitomo Ashitate; Clemens W. G. M. ...; Vincent T. H. B. ...; Rafiou Oketokoun; Long H. Ngo; Cornelis J. H. va...; John V. Frangioni; Alexander L. Vahr...
• Keywords: Indocyanine Green; Fluorescence-lifetime imaging microscopy

Near-infrared (NIR) fluorescent sentinel lymph node (SLN) mapping in breast cancer requires optimized imaging systems and lymphatic tracers.A small, portable version of the FLARE system, termed Mini-FLARE, was developed for capturing color video two semi-independent channels NIR fluorescence (700 800 nm) real time. Initial optimization tracer dose performed using 35-kg Yorkshire pigs a 6-patient pilot clinical trial. More refined 24 consecutive patients. All patients received standard care (99m)Technetium-nanocolloid patent blue. In addition, 1.6 ml indocyanine green adsorbed to human serum albumin (ICG:HSA) injected directly after blue at same location. Patients were allocated 1 8 escalating ICG:HSA concentration groups from 50 1000 μM.The Mini-FLARE system positioned easily operating room could be used up 13 in. patient. enabled visualization SLNs all A total 35 (mean = 1.45, range 1-3) detected: radioactive (100%), 30 (86%), (100%). Contrast agent quenching injection site dilution within major contributors signal strength SLN. Optimal ranged between 400 μM. No adverse reactions observed.We describe translation new define optimal SLN cancer.