Investigating the use of Indocyanine Green (ICG) to detect sentinel lymph nodes in penile cancer – an eUROGEN feasibility study
BAUS ePoster online library. Alnajjar H. 11/10/20; 304181; P6-7 Disclosure(s): None
Mr. Hussain Alnajjar
Mr. Hussain Alnajjar
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Investigating the use of Indocyanine Green (ICG) to detect sentinel lymph nodes in penile cancer – an eUROGEN feasibility study

Alnajjar H1, Cakir O1, Pozzi E1, Venturino L1, Muneer A1,2,3
1University College London Hospitals, United Kingdom, 2NIHR Biomedical Research Centre University College London Hospitals, United Kingdom, 3Division of Surgery and Interventional Science, UCL, United Kingdom

Introduction:
Dynamic sentinel lymph node biopsy (DSNB) currently uses a combination of 99mTc nanocolloid and blue dye followed by an inguinal exploration and detection using a hand-held gamma probe. Although sentinel lymph nodes (SLN) are found to have radioactivity, they often do not take-up the blue dye. The aim of this feasibility study was to investigate the concordance of 99mTc/ICG/blue dye.
Patients & Methods: A prospective study of 19 patients diagnosed with primary penile SCC (cN0) at presentation. Median age, site of primary lesion, pT stage, grade, type of primary surgery and post-surgical complications were assessed. All patients were injected with 99mTc, blue dye and ICG. Preoperative imaging with lymphoscintigram and SPECT/CT was performed. Radioactivity in the SLN was considered the gold standard. ICG fluorescence was detected using a hand-held detector (Hamamatsu, Japan). The presence of blue dye and ICG fluorescence was recorded. Descriptive statistics was used to compare detection rates between 99mTc/blue dye/ICG.

Results:
Median (IQR) age at presentation was 67 (57-74). All patients had primary penile SCC at presentation. In total, 36 inguinal basins and 57 nodes were assessed. There were no reported post-operative complications. (Tables 1 & 2)

Conclusions:
Using a combination of 99mTc and ICG improves the detection rate of the SLN, compared to 99mTc and blue dye during DSNB. ICG also has the advantage that there is no residual tattooing of the penile skin. In this study ICG has a superior detection compared to blue dye and represents a useful alternative in combination with 99mTc.
Investigating the use of Indocyanine Green (ICG) to detect sentinel lymph nodes in penile cancer – an eUROGEN feasibility study

Alnajjar H1, Cakir O1, Pozzi E1, Venturino L1, Muneer A1,2,3
1University College London Hospitals, United Kingdom, 2NIHR Biomedical Research Centre University College London Hospitals, United Kingdom, 3Division of Surgery and Interventional Science, UCL, United Kingdom

Introduction:
Dynamic sentinel lymph node biopsy (DSNB) currently uses a combination of 99mTc nanocolloid and blue dye followed by an inguinal exploration and detection using a hand-held gamma probe. Although sentinel lymph nodes (SLN) are found to have radioactivity, they often do not take-up the blue dye. The aim of this feasibility study was to investigate the concordance of 99mTc/ICG/blue dye.
Patients & Methods: A prospective study of 19 patients diagnosed with primary penile SCC (cN0) at presentation. Median age, site of primary lesion, pT stage, grade, type of primary surgery and post-surgical complications were assessed. All patients were injected with 99mTc, blue dye and ICG. Preoperative imaging with lymphoscintigram and SPECT/CT was performed. Radioactivity in the SLN was considered the gold standard. ICG fluorescence was detected using a hand-held detector (Hamamatsu, Japan). The presence of blue dye and ICG fluorescence was recorded. Descriptive statistics was used to compare detection rates between 99mTc/blue dye/ICG.

Results:
Median (IQR) age at presentation was 67 (57-74). All patients had primary penile SCC at presentation. In total, 36 inguinal basins and 57 nodes were assessed. There were no reported post-operative complications. (Tables 1 & 2)

Conclusions:
Using a combination of 99mTc and ICG improves the detection rate of the SLN, compared to 99mTc and blue dye during DSNB. ICG also has the advantage that there is no residual tattooing of the penile skin. In this study ICG has a superior detection compared to blue dye and represents a useful alternative in combination with 99mTc.
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