Near infrared fluorescent imaging after intravenous injection of indocyanine green during neck dissection in patients with head and neck cancer: A feasibility study

Background. Indocyanine green (ICG) has not been studied during therapeutic lymph node dissections after intravenous injection. The purpose of this study was to explore the distribution of ICG in lymphatic nodes during neck dissection. Methods. Eleven patients requiring neck dissection with or without resection of the primary lesion were included. ICG was intravenously injected at induction time of anesthesia. Imaging was performed before and after surgical resection. Fluorescence was measured in arbitrary units (AUs) in the pathology department. Mixed linear model and generalized estimating equations (GEEs) were used. Results. Mean fluorescence of invaded nodes was 22.6 AUs (SD = 24.9) and 3.9 AUs (SD = 8.1) in negative nodes (p = .016). After adjustment for the size of the node, the risk of invasion when fluorescence was observed was 12.2 (95% confidence interval [CI] = 5.3-28.2; p < .0001). Conclusion. This study demonstrates the feasibility of ICG to bring a contrast during surgery between healthy and invaded nodes after i.v. injection. (C) 2015 Wiley Periodicals, Inc.