ArticlePloS one2015
Minimally invasive electro-magnetic navigational bronchoscopy-integrated near-infrared-guided sentinel lymph node mapping in the porcine lung.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 13 citations in OpenAlex.
- A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer.The Journal of thoracic and cardiovascular surgery · 2017Trial
- A Novel Fluorescence-Triggered Auditory Feedback Photosensor for Precision Lymph Node Mapping.Sensors (Basel, Switzerland) · 2026Article
- Feasibility of intraoperative indocyanine green injection to identify lymph nodes at risk of metastatic disease for early-stage lung cancer.JTCVS techniques · 2025Article
- Sentinel lymph node biopsy for lung cancer.General thoracic and cardiovascular surgery · 2020Review
- Constant-rate intravenous infusion of indocyanine green leading to high fluorescence intensity in infrared thoracoscopic segmentectomy.JTCVS techniques · 2020Article
- Sentinel lymph node mapping in lung cancer: a step forward?Journal of thoracic disease · 2018Article
- Image-guided thoracic surgery in the hybrid operation room.Journal of visualized surgery · 2017Review
- Combination of Fluorescence-Guided Surgery With Photodynamic Therapy for the Treatment of Cancer.Molecular imagingReview
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Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of near-infrared (NIR) fluorescence imaging with indocyanine green (ICG) for sentinel lymph node (SN) mapping has been investigated in lung cancer; however, this has not been fully adapted for minimally invasive surgery (MIS). The aim of our study was to develop a minimally invasive SN mapping integrating pre-operative electro-magnetic navigational bronchoscopy (ENB)-guided transbronchial ICG injection and intraoperative NIR thoracoscopic imaging.
methodsA NIR thoracoscope was used to visualize ICG fluorescence. ICG solutions in a 96-well plate and ex vivo porcine lungs were examined to optimize ICG concentrations and injection volumes. Transbronchial ICG injection (n=4) was assessed in comparison to a traditional transpleural approach (n=3), where after thoracotomy an ICG solution (100 μL at 100 μg/mL) was injected into the porcine right upper lobe for SN identification. For further translation into clinical use, transbronchial ICG injection prior to thoracotomy followed by NIR thoracoscopic imaging was validated (n=3). ENB was used for accurate targeting in two pigs with a pseudo-tumor.
resultsThe ICG fluorescence at 10 μg/mL was the brightest among various concentrations, unchanged by the distance between the thoracoscope and ICG solutions. Injected ICG of no more than 500μ L showed a localized fluorescence area. All 7 pigs showed a bright paratracheal lymph node within 15 minutes post-injection, with persistent fluorescence for 60 minutes. The antecedent transbronchial ICG injection succeeded in SN identification in all 3 cases at the first thoracoscopic inspection within 20 minutes post-injection. The ENB system allowed accurate ICG injection surrounding the pseudo-tumors.
conclusionsENB-guided ICG injection followed by NIR thoracoscopy was technically feasible for SN mapping in the porcine lung. This promising platform may be translated into human clinical trials and is suited for MIS.
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