Indocyanine green fluorescence applied to gynecologic oncology: beyond sentinel lymph node

Author:

Loverro M.1,Bizzarri N.1,Capomacchia F.M.2,Watrowski Rafał34,Querleu D.1,Gioè A.1,Naldini A.1,Santullo F.5,Foschi N.6,Fagotti A.12,Scambia G.12,Fanfani F.12

Affiliation:

1. UOC Ginecologia Oncologica, Dipartimento di Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy

2. Università Cattolica del Sacro Cuore, Rome, Italy

3. Department of Gynecology and Obsterics, Helios Hospital Müllheim, Teaching Hospital of the University of Freiburg, 79379 Müllheim, Germany

4. Faculty of Medicine, Medical Center - University of Freiburg, 79106 Freiburg, Germany

5. Operational Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy

6. Urology Division, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy

Abstract

Indocyanine green (ICG), a well-known molecule employed in medicine for over five decades, has emerged as a versatile dye widely embraced across various surgical disciplines. In gynecologic oncology, its prevalent use revolves around the detection of sentinel lymph nodes. However, the true potential of ICG extends beyond this singular application, owing to its pragmatic utility, cost-effectiveness, and safety profile. Furthermore, ICG has been introduced in the theranostic landscape, marking a significant juncture in the evolution of its clinical utility. This narrative review aims to describe the expanding horizons of ICG fluorescence in gynecologic oncology, beyond the sentinel lymph node biopsy. The manifold applications reported within this manuscript include: 1) lymphography; 2) angiography; 3) nerve visualization; 4) ICG-driven resections; and 5) theranostic. The extensive exploration across these numerous applications, some of which are still in the pre-clinical phase, serves as a hypothesis generator, aiming to stimulate the development of clinical studies capable of expanding the use of this drug in our field, enhancing the care of gynecological cancer patients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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