Article Text

Download PDFPDF
EP661 Sentinel node mapping with indocyanine green and endoscopic near-infrared fluorescence imaging in endometrial and cervical cancer: a systematic review to assess impact of technical aspects on detection rate and diagnostic performance
  1. K Zalewski1,
  2. J Kacperczyk-Bartnik2,
  3. A Strojna3,
  4. M Szubert4,
  5. K Nowosielski5,
  6. P Lepka6,7,
  7. M Mardas8,
  8. M Bałajewicz-Nowak9,
  9. N Abdalla10,
  10. M Bobiński11,
  11. Club of Young Gynecologic Oncologists12
  1. 1Department of Gynecologic Oncology, Holycross Cancer Center, Kielce
  2. 2Second Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw
  3. 3Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin
  4. 4Clinic for Surgical Gynecology and Oncology, I Departament of Gynecology and Obstetrics, Medical University of Lodz, Lodz
  5. 5Department of Gynecology and Gynecological Oncology, Teaching Hospital in Czeladz, Czeladz
  6. 6Division of Surgical Oncology, Gynecological Oncology, Chemotherapy and Department of Oncology, Wroclaw Medical University
  7. 7Gynecologic Oncology Department, Lower Silesian Oncology Center, Wroclaw
  8. 8Department of Oncology, Poznan University of Medical Sciences, Poznan
  9. 9Department of Gynecology and Oncology, University Hospital in Krakow, Krakow
  10. 10Department of Obstetrics, Gynaecology and Oncology, II Faculty of Medicine, Medical University of Warsaw, Warsaw
  11. 111st Chair and Department of Gynecological Oncology and Gynecology, Medical University in Lublin, Lublin, Poland
  12. 12Polish Society of Gynecological Oncology, Poland


Introduction/Background Sentinel lymph node (SLN) biopsy has been recently widely investigated in endometrial (EC) and cervical cancer (CC). Near-infrared (NIR) fluorescence imaging is rapidly gaining popularity despite being a relatively new technique associated with lack of uniformity in the application of the method used across centers. The aim of presented systematic review is to gather evidence regarding different technical aspects and their impact on the effectiveness of indocyanine green (ICG) use during SLN mapping.

Methodology A computer literature search using Medline was conducted for studies in EC and CC patients published in between January 2010 and May 2019. The initial search came up with 207 articles, of which 91 articles used ICG as a tracer.

Results 7446 patients were included in the final analysis, ranging from 1 to 472 patients per study. The main surgical approach was laparoscopy, followed by robotic surgery, laparotomy, hysteroscopy and natural orifice transluminal endoscopic surgery. The overall SLN detection rate using ICG ranged from 64% to 100% for cervical, from 83% to 100% for fundal and from 33% to 100% for hysteroscopic injections. Sensitivity and negative predictive value varied from 77,8% to 100% and 83% to 100%, respectively. The most common site of injection was the cervix injected submucosally and intrastromally in two quadrants. There is a large variation in the size of the needle, dilution solvent, concentration, dosage and volume of ICG injected as well as the time when the dye is injected and the period between injection and beginning of the dissection.

Conclusion ICG shows a high overall detection rate as well as sensitivity and specificity in SLN mapping in patients with EC and CC. The differences in results obtained in particular studies suggest that the details of injection procedure might influence the success rate in SLN detection.

Disclosure Nothing to disclose.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.