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Proceedings Paper

Sentinel lymph node detection in gynecologic malignancies by a handheld fluorescence camera
Author(s): Ole Hirsch; Lukasz Szyc; Mustafa Zelal Muallem; Iulia Ignat; Radoslav Chekerov; Rainer Macdonald; Jalid Sehouli; Ioana Braicu; Dirk Grosenick
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Paper Abstract

Near-infrared fluorescence imaging using indocyanine green (ICG) as a tracer is a promising technique for mapping the lymphatic system and for detecting sentinel lymph nodes (SLN) during cancer surgery. In our feasibility study we have investigated the application of a custom-made handheld fluorescence camera system for the detection of lymph nodes in gynecological malignancies. It comprises a low cost CCD camera with enhanced NIR sensitivity and two groups of LEDs emitting at wavelengths of 735 nm and 830 nm for interlaced recording of fluorescence and reflectance images of the tissue, respectively. With the help of our system, surgeons can observe fluorescent tissue structures overlaid onto the anatomical image on a monitor in real-time. We applied the camera system for intraoperative lymphatic mapping in 5 patients with vulvar cancer, 5 patients with ovarian cancer, 3 patients with cervical cancer, and 3 patients with endometrial cancer. ICG was injected at four loci around the primary malignant tumor during surgery. After a residence time of typically 15 min fluorescence images were taken in order to visualize the lymph nodes closest to the carcinomas. In cases with vulvar cancer about half of the lymph nodes detected by routinely performed radioactive SLN mapping have shown fluorescence in vivo as well. In the other types of carcinomas several lymph nodes could be detected by fluorescence during laparotomy. We conclude that our low cost camera system has sufficient sensitivity for lymphatic mapping during surgery.

Paper Details

Date Published: 17 February 2017
PDF: 9 pages
Proc. SPIE 10059, Optical Tomography and Spectroscopy of Tissue XII, 100591B (17 February 2017); doi: 10.1117/12.2250723
Show Author Affiliations
Ole Hirsch, Physikalisch-Technische Bundesanstalt (Germany)
Lukasz Szyc, Physikalisch-Technische Bundesanstalt (Germany)
Mustafa Zelal Muallem, Charité Univ. Medicine Berlin (Germany)
Iulia Ignat, Charité Univ. Medicine Berlin (Germany)
Radoslav Chekerov, Charité Univ. Medicine Berlin (Germany)
Rainer Macdonald, Physikalisch-Technische Bundesanstalt (Germany)
Jalid Sehouli, Charité Univ. Medicine Berlin (Germany)
Ioana Braicu, Charité Univ. Medicine Berlin (Germany)
Dirk Grosenick, Physikalisch-Technische Bundesanstalt (Germany)


Published in SPIE Proceedings Vol. 10059:
Optical Tomography and Spectroscopy of Tissue XII
Bruce J. Tromberg; Arjun G. Yodh; Eva Marie Sevick-Muraca; Robert R. Alfano, Editor(s)

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