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P1241 Feasibility of real-time near-infrared fluorescence tracer imaging in sentinel node biopsy for vulva cancer patients
  1. L Paskeviciute Frøding,
  2. V Zobbe,
  3. A Christensen,
  4. J Mortensen,
  5. C Hoegdall,
  6. A Kjaer,
  7. K Juhl and
  8. T Henrichsen Schnack
  1. Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark


Introduction/Background Sentinel node (SN) biopsy is a safe staging method in patients with vulva cancer (VC). Near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG) has recently been introduced to improve the visual intraoperative SN identification. The purpose of this study was to evaluate the feasibility of fluorescence tracer imaging for SN detection in conjunction with conventional radio-guided technique.

Methodology Prospective study of patients with primary VC planned for vulvectomy and SN procedure. Bimodal tracer (ICG-99mTc-Nanocoll) was injected peritumorally and followed by lymphoscintigraphy and SPECT/CT to define the SNs. Intraoperatively SNs were detected with a hand-held gamma-probe and NIRF camera. The detection rate was defined as the proportion of patients with at least one SN detected in at least one groin on scintigraphy or perioperatively (using gamma-probe and NIRF camera).

Results SN procedure was performed in 36 patients (14 uni- and 22 bilaterally), corresponding to 58 groins. At least one SN was detected in 52 of 58 intended groins (90%) on scintigraphy, while perioperatively SN was identified in 54 of 58 groins (93%). In 14 patients with lateralized tumor and in 22 patients with midline tumor (<1 cm from midline) the unilateral SN detection rate was 100%. In patients with midline tumors the bilateral detection rate on scintigraphy and perioperatively was 77% and 82% respectively. In one patient with a midline tumor and no-detectable SNs bilaterally on scintigraphy and in three of four patients with midline tumor and no-detectable SNs in one side on scintigraphy, the SN was detected perioperatively by NIRF only. In 11 of 58 groins (19%) the SN could only be identified by NIRF.

Conclusion A combined fluorescent and radioactive tracer for SN procedure is feasible, and the additional use of NIRF imaging may improve the accuracy of SN identification in VC patients.

Disclosure Nothing to disclose.

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