Meta-analysis Comparing Fluorescence Imaging with Radioisotope and Blue Dye-Guided Sentinel Node Identification for Breast Cancer Surgery

Introduction Conventional methods for axillary sentinel lymph node biopsy (SLNB) are fraught with complications such as allergic reactions, skin tattooing, radiation, and limitations on infrastructure. A novel technique has been developed for lymphatic mapping utilizing fluorescence imaging. This me...

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Bibliographic Details
Published in:Annals of surgical oncology 2021-07, Vol.28 (7), p.3738-3748
Main Authors: Kedrzycki, Martha S., Leiloglou, Maria, Ashrafian, Hutan, Jiwa, Natasha, Thiruchelvam, Paul T. R., Elson, Daniel S., Leff, Daniel R.
Format: Article
Language:English
Subjects:
Biopsy
Breast cancer
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - surgery
Breast Oncology
Cancer surgery
Coloring Agents
Dyes
Female
Fluorescence
Humans
Hypersensitivity
Indocyanine Green
Lymph nodes
Lymphatic system
Medicine
Medicine & Public Health
Meta-analysis
Oncology
Optical Imaging
Radioisotopes
Sentinel Lymph Node - diagnostic imaging
Sentinel Lymph Node - surgery
Sentinel Lymph Node Biopsy
Surgery
Surgical Oncology
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Summary:Introduction Conventional methods for axillary sentinel lymph node biopsy (SLNB) are fraught with complications such as allergic reactions, skin tattooing, radiation, and limitations on infrastructure. A novel technique has been developed for lymphatic mapping utilizing fluorescence imaging. This meta-analysis aims to compare the gold standard blue dye and radioisotope (BD-RI) technique with fluorescence-guided SLNB using indocyanine green (ICG). Methods This study was registered with PROSPERO (CRD42019129224). The MEDLINE, EMBASE, Scopus, and Web of Science databases were searched using the Medical Subject Heading (MESH) terms ‘Surgery’ AND ‘Lymph node’ AND ‘Near infrared fluorescence’ AND ‘Indocyanine green’. Studies containing raw data on the sentinel node identification rate in breast cancer surgery were included. A heterogeneity test (using Cochran’s Q) determined the use of fixed- or random-effects models for pooled odds ratios (OR). Results Overall, 1748 studies were screened, of which 10 met the inclusion criteria for meta-analysis. ICG was equivalent to radioisotope (RI) at sentinel node identification (OR 2.58, 95% confidence interval [CI] 0.35–19.08, p 
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-020-09288-7