Back to Annual Meeting Program

Background: Early stage lung cancer, as compared with other solid tumors, has a high recurrence rate and low 5-year survival rate. Lymph node metastasis is the most important prognostic factor in non-small cell lung cancer (NSCLC) but false negative rates of lymph node sampling and analysis may result in understaging of disease. To date, sentinel lymph node (SLN) identification has been only moderately successful. Recent clinical trials have utilized near-infrared (NIR) fluorescence imaging and indocyanine green (ICG) to identify SLN intra-operatively. This study assesses safety and feasibility of NIR lymphatic mapping using ICG in patients with early stage lung cancer.
Methods: A Phase I trial determining safety and feasibility of NIR imaging as a function of ICG was studied in patients with stage I/II NSCLC. Using a 10mm NIR thoracoscope to obtain images, peritumoral injection of ICG coupled with albumin was injected intraparenchymal followed by short period of lung ventilation in an intraoperative clinical setting.
Results: Minimally invasive NIR imaging was utilized to successfully visualize ICG at the injection site, lymphatic migration and the sentinel lymph node in 5-10 minutes following injection.
Conclusion: Minimally invasive intrathoracic SLN visualization in patients with lung cancer can be accomplished using NIR imaging and intraparenchymal injection of ICG coupled with albumin followed by short ventilation. NIR imaging with ICG is both safe and feasible without an adverse event reported in the first 29 patients. Further studies are needed to confirm the dose, specificity and sensitivity of sentinel lymph node mapping in non small cell lung cancer.