Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey

Danny A. Sherwinter; Luigi Boni; Michael Bouvet; Lorenzo Ferri; Woo Jin Hyung; Takeaki Ishizawa; Ronald N. Kaleya; Kaitlyn Kelly; Norihiro Kokudo; Enrique Lanzarini; Misha D.P. Luyer; Norio Mitsumori; Carmen Mueller; Doo Joong Park; Dario Ribero; Riccardo Rosati; Jelle P. Ruurda; Meindert Sosef; Sylke Schneider-Koraith; Giuseppe Spinoglio; Vivian Strong; Naoto Takahashi; Hiroya Takeuchi; Bas P.L. Wijnhoven; Han Kwang Yang; Fernando Dip; Emanuele Lo Menzo; Kevin P. White; Raul J. Rosenthal

doi:10.1016/j.surg.2022.06.036

Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey

Danny A. Sherwinter, Luigi Boni, Michael Bouvet, Lorenzo Ferri, Woo Jin Hyung, Takeaki Ishizawa, Ronald N. Kaleya, Kaitlyn Kelly, Norihiro Kokudo, Enrique Lanzarini, Misha D.P. Luyer, Norio Mitsumori, Carmen Mueller, Doo Joong Park, Dario Ribero, Riccardo Rosati, Jelle P. Ruurda, Meindert Sosef, Sylke Schneider-Koraith, Giuseppe SpinoglioVivian Strong, Naoto Takahashi, Hiroya Takeuchi, Bas P.L. Wijnhoven, Han Kwang Yang, Fernando Dip, Emanuele Lo Menzo, Kevin P. White, Raul J. Rosenthal

Department of Surgery

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Understanding the extent of tumor spread to local lymph nodes is critical to managing early-stage gastric cancer. Recently, fluorescence imaging with indocyanine green has been used to identify and characterize sentinel lymph nodes during gastric cancer surgery, but no published guidelines exist. We sought to identify areas of consensus among international experts in the use of fluorescence imaging with indocyanine green for mapping sentinel lymph nodes during gastric-cancer surgery. Methods: In this 2-round, online Delphi survey, 27 international experts voted on 79 statements pertaining to patient preparation and contraindications to fluorescence imaging with indocyanine green during gastric cancer surgery; indications; technical aspects; advantages/disadvantages and limitations; and training and research. Methodological steps were adopted during survey design to minimize bias. Results: Consensus was reached on 61 of 79 statements, including giving single injections of indocyanine green into each of the 4 quadrants peritumorally, administering indocyanine green on the same day as surgery, injecting a total of 1 to 5 mL of 5 mg/mL indocyanine green, injecting endoscopically into submucosa, and repeating indocyanine green injections a second time if sentinel lymph node visualization remains inadequate. Consensus also was reached that fluorescence imaging with indocyanine green is an acceptable single-agent modality for sentinel lymph node identification and that the sentinel lymph node basin method is preferred. However, sentinel lymph node dissection should be limited to T1 gastric cancer and tumors ≤4 cm in diameter, and further research is necessary to optimize the technique and render fluorescence-guided sentinel lymph nodes dissection acceptable for routine clinical use. Conclusion: Although considerable consensus was achieved, further research is necessary before this technology should be used in routine practice.

Original language	English
Pages (from-to)	S29-S37
Journal	Surgery (United States)
Volume	172
Issue number	6
DOIs	https://doi.org/10.1016/j.surg.2022.06.036
Publication status	Published - 2022 Dec

Bibliographical note

Funding Information:
Danny Sherwinter, Luigi Boni, Michael Bouvet, Takeaki Ishizawa, Norihiro Kokudo, Sylke Schneider-Koraith, Giuseppe Spinoglio, Fernando Dip, Emanuele Lo Menzo, Kevin White, and Raul Rosenthal are members of the ISFGS Advisory Board. None of the industry sponsors were actively involved in any process of the Delphi consensus or drafting, review, or revision of the manuscript. All companies are sponsors/Corporate Council members of the ISFGS.

Funding Information:
This article is published as part of a supplement supported by the International Society for Fluorescence Guided Surgery (ISFGS) with funding from Arthrex, Diagnostic Green, Intuitive, Medtronic, Olympus, Karl Storz Endoscopy, Stryker, and Richard Wolf.

Publisher Copyright:
© 2022

All Science Journal Classification (ASJC) codes

Surgery

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.surg.2022.06.036

Cite this

Sherwinter, D. A., Boni, L., Bouvet, M., Ferri, L., Hyung, W. J., Ishizawa, T., Kaleya, R. N., Kelly, K., Kokudo, N., Lanzarini, E., Luyer, M. D. P., Mitsumori, N., Mueller, C., Park, D. J., Ribero, D., Rosati, R., Ruurda, J. P., Sosef, M., Schneider-Koraith, S., ... Rosenthal, R. J. (2022). Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey. Surgery (United States), 172(6), S29-S37. https://doi.org/10.1016/j.surg.2022.06.036

@article{8406a589c0f941728891c9e5ab998c93,

title = "Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey",

abstract = "Background: Understanding the extent of tumor spread to local lymph nodes is critical to managing early-stage gastric cancer. Recently, fluorescence imaging with indocyanine green has been used to identify and characterize sentinel lymph nodes during gastric cancer surgery, but no published guidelines exist. We sought to identify areas of consensus among international experts in the use of fluorescence imaging with indocyanine green for mapping sentinel lymph nodes during gastric-cancer surgery. Methods: In this 2-round, online Delphi survey, 27 international experts voted on 79 statements pertaining to patient preparation and contraindications to fluorescence imaging with indocyanine green during gastric cancer surgery; indications; technical aspects; advantages/disadvantages and limitations; and training and research. Methodological steps were adopted during survey design to minimize bias. Results: Consensus was reached on 61 of 79 statements, including giving single injections of indocyanine green into each of the 4 quadrants peritumorally, administering indocyanine green on the same day as surgery, injecting a total of 1 to 5 mL of 5 mg/mL indocyanine green, injecting endoscopically into submucosa, and repeating indocyanine green injections a second time if sentinel lymph node visualization remains inadequate. Consensus also was reached that fluorescence imaging with indocyanine green is an acceptable single-agent modality for sentinel lymph node identification and that the sentinel lymph node basin method is preferred. However, sentinel lymph node dissection should be limited to T1 gastric cancer and tumors ≤4 cm in diameter, and further research is necessary to optimize the technique and render fluorescence-guided sentinel lymph nodes dissection acceptable for routine clinical use. Conclusion: Although considerable consensus was achieved, further research is necessary before this technology should be used in routine practice.",

author = "Sherwinter, {Danny A.} and Luigi Boni and Michael Bouvet and Lorenzo Ferri and Hyung, {Woo Jin} and Takeaki Ishizawa and Kaleya, {Ronald N.} and Kaitlyn Kelly and Norihiro Kokudo and Enrique Lanzarini and Luyer, {Misha D.P.} and Norio Mitsumori and Carmen Mueller and Park, {Doo Joong} and Dario Ribero and Riccardo Rosati and Ruurda, {Jelle P.} and Meindert Sosef and Sylke Schneider-Koraith and Giuseppe Spinoglio and Vivian Strong and Naoto Takahashi and Hiroya Takeuchi and Wijnhoven, {Bas P.L.} and Yang, {Han Kwang} and Fernando Dip and {Lo Menzo}, Emanuele and White, {Kevin P.} and Rosenthal, {Raul J.}",

note = "Funding Information: Danny Sherwinter, Luigi Boni, Michael Bouvet, Takeaki Ishizawa, Norihiro Kokudo, Sylke Schneider-Koraith, Giuseppe Spinoglio, Fernando Dip, Emanuele Lo Menzo, Kevin White, and Raul Rosenthal are members of the ISFGS Advisory Board. None of the industry sponsors were actively involved in any process of the Delphi consensus or drafting, review, or revision of the manuscript. All companies are sponsors/Corporate Council members of the ISFGS. Funding Information: This article is published as part of a supplement supported by the International Society for Fluorescence Guided Surgery (ISFGS) with funding from Arthrex, Diagnostic Green, Intuitive, Medtronic, Olympus, Karl Storz Endoscopy, Stryker, and Richard Wolf. Publisher Copyright: {\textcopyright} 2022",

year = "2022",

month = dec,

doi = "10.1016/j.surg.2022.06.036",

language = "English",

volume = "172",

pages = "S29--S37",

journal = "Surgery",

issn = "0039-6060",

publisher = "Mosby Inc.",

number = "6",

}

Sherwinter, DA, Boni, L, Bouvet, M, Ferri, L, Hyung, WJ, Ishizawa, T, Kaleya, RN, Kelly, K, Kokudo, N, Lanzarini, E, Luyer, MDP, Mitsumori, N, Mueller, C, Park, DJ, Ribero, D, Rosati, R, Ruurda, JP, Sosef, M, Schneider-Koraith, S, Spinoglio, G, Strong, V, Takahashi, N, Takeuchi, H, Wijnhoven, BPL, Yang, HK, Dip, F, Lo Menzo, E, White, KP & Rosenthal, RJ 2022, 'Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey', Surgery (United States), vol. 172, no. 6, pp. S29-S37. https://doi.org/10.1016/j.surg.2022.06.036

TY - JOUR

T1 - Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery

T2 - Results of an intercontinental Delphi survey

AU - Sherwinter, Danny A.

AU - Boni, Luigi

AU - Bouvet, Michael

AU - Ferri, Lorenzo

AU - Hyung, Woo Jin

AU - Ishizawa, Takeaki

AU - Kaleya, Ronald N.

AU - Kelly, Kaitlyn

AU - Kokudo, Norihiro

AU - Lanzarini, Enrique

AU - Luyer, Misha D.P.

AU - Mitsumori, Norio

AU - Mueller, Carmen

AU - Park, Doo Joong

AU - Ribero, Dario

AU - Rosati, Riccardo

AU - Ruurda, Jelle P.

AU - Sosef, Meindert

AU - Schneider-Koraith, Sylke

AU - Spinoglio, Giuseppe

AU - Strong, Vivian

AU - Takahashi, Naoto

AU - Takeuchi, Hiroya

AU - Wijnhoven, Bas P.L.

AU - Yang, Han Kwang

AU - Dip, Fernando

AU - Lo Menzo, Emanuele

AU - White, Kevin P.

AU - Rosenthal, Raul J.

N1 - Funding Information: Danny Sherwinter, Luigi Boni, Michael Bouvet, Takeaki Ishizawa, Norihiro Kokudo, Sylke Schneider-Koraith, Giuseppe Spinoglio, Fernando Dip, Emanuele Lo Menzo, Kevin White, and Raul Rosenthal are members of the ISFGS Advisory Board. None of the industry sponsors were actively involved in any process of the Delphi consensus or drafting, review, or revision of the manuscript. All companies are sponsors/Corporate Council members of the ISFGS. Funding Information: This article is published as part of a supplement supported by the International Society for Fluorescence Guided Surgery (ISFGS) with funding from Arthrex, Diagnostic Green, Intuitive, Medtronic, Olympus, Karl Storz Endoscopy, Stryker, and Richard Wolf. Publisher Copyright: © 2022

PY - 2022/12

Y1 - 2022/12

N2 - Background: Understanding the extent of tumor spread to local lymph nodes is critical to managing early-stage gastric cancer. Recently, fluorescence imaging with indocyanine green has been used to identify and characterize sentinel lymph nodes during gastric cancer surgery, but no published guidelines exist. We sought to identify areas of consensus among international experts in the use of fluorescence imaging with indocyanine green for mapping sentinel lymph nodes during gastric-cancer surgery. Methods: In this 2-round, online Delphi survey, 27 international experts voted on 79 statements pertaining to patient preparation and contraindications to fluorescence imaging with indocyanine green during gastric cancer surgery; indications; technical aspects; advantages/disadvantages and limitations; and training and research. Methodological steps were adopted during survey design to minimize bias. Results: Consensus was reached on 61 of 79 statements, including giving single injections of indocyanine green into each of the 4 quadrants peritumorally, administering indocyanine green on the same day as surgery, injecting a total of 1 to 5 mL of 5 mg/mL indocyanine green, injecting endoscopically into submucosa, and repeating indocyanine green injections a second time if sentinel lymph node visualization remains inadequate. Consensus also was reached that fluorescence imaging with indocyanine green is an acceptable single-agent modality for sentinel lymph node identification and that the sentinel lymph node basin method is preferred. However, sentinel lymph node dissection should be limited to T1 gastric cancer and tumors ≤4 cm in diameter, and further research is necessary to optimize the technique and render fluorescence-guided sentinel lymph nodes dissection acceptable for routine clinical use. Conclusion: Although considerable consensus was achieved, further research is necessary before this technology should be used in routine practice.

AB - Background: Understanding the extent of tumor spread to local lymph nodes is critical to managing early-stage gastric cancer. Recently, fluorescence imaging with indocyanine green has been used to identify and characterize sentinel lymph nodes during gastric cancer surgery, but no published guidelines exist. We sought to identify areas of consensus among international experts in the use of fluorescence imaging with indocyanine green for mapping sentinel lymph nodes during gastric-cancer surgery. Methods: In this 2-round, online Delphi survey, 27 international experts voted on 79 statements pertaining to patient preparation and contraindications to fluorescence imaging with indocyanine green during gastric cancer surgery; indications; technical aspects; advantages/disadvantages and limitations; and training and research. Methodological steps were adopted during survey design to minimize bias. Results: Consensus was reached on 61 of 79 statements, including giving single injections of indocyanine green into each of the 4 quadrants peritumorally, administering indocyanine green on the same day as surgery, injecting a total of 1 to 5 mL of 5 mg/mL indocyanine green, injecting endoscopically into submucosa, and repeating indocyanine green injections a second time if sentinel lymph node visualization remains inadequate. Consensus also was reached that fluorescence imaging with indocyanine green is an acceptable single-agent modality for sentinel lymph node identification and that the sentinel lymph node basin method is preferred. However, sentinel lymph node dissection should be limited to T1 gastric cancer and tumors ≤4 cm in diameter, and further research is necessary to optimize the technique and render fluorescence-guided sentinel lymph nodes dissection acceptable for routine clinical use. Conclusion: Although considerable consensus was achieved, further research is necessary before this technology should be used in routine practice.

UR - http://www.scopus.com/inward/record.url?scp=85142940796&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85142940796&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2022.06.036

DO - 10.1016/j.surg.2022.06.036

M3 - Article

C2 - 36427927

AN - SCOPUS:85142940796

SN - 0039-6060

VL - 172

SP - S29-S37

JO - Surgery

JF - Surgery

IS - 6

ER -

Use of fluorescence imaging and indocyanine green for sentinel node mapping during gastric cancer surgery: Results of an intercontinental Delphi survey

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this