![]() However, a clinical dilemma as to the scope of cervical lymph node management can arise when the patient has a clinically N0 neck, as 20–30% of patients have occult regional disease not detectable on pre-operative imaging or clinical examination. This pre-clinical study further demonstrates the technical feasibility, limitations and advantages of intraoperative NIR-guided ICG imaging for SLN identification as a complementary method during head and neck surgery.įor patients with early stage (T1/T2) oral squamous cell carcinoma, surgical resection of the primary tumor is typically the preferred first-line treatment. CBCT was useful for near real time intraoperative imaging and 3D reconstruction. Intraoperative use of ICG to guide fluorescence resection resulted in identification of all lymph nodes identified by pre-operative CT. During surgery, CBCT and NIR fluorescence imaging of ICG was used to map and guide the SLNB resection. Pre-operatively, images were acquired by MicroCT. This was a prospective, non-randomized study using a rabbit oral cavity VX2 squamous cell carcinoma model ( n = 10) which develops lymph node metastasis. However, limited literature exists regarding their use in head and neck cancer SLNB. Indocyanine green (ICG) based near-infrared (NIR) fluorescence imaging and cone beam CT (CBCT) have advantages for intraoperative use. Current sentinel lymph node biopsy (SLNB) techniques, including use of radioisotopes, have disadvantages including the use of a radioactive tracer.
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