Nahinfrarot-Sentinel-Diagnostik bei Kopf-Hals-Plattenepithelkarzinomen: eine systematische Übersicht

Zusammenfassung

Hintergrund Die Nahinfrarot-Fluoreszenzbildgebung (NIR) ist eine neue Technik zur intraoperativen Identifizierung von Sentinel-Lymphknoten (SLN). Sie hat in mehreren chirurgischen Fachgebieten vielversprechende Ergebnisse gezeigt. Dieser Artikel gibt einen Überblick über die aktuelle Studienlage der NIR-SLN-Diagnostik des Kopf-Hals-Malignoms.

Material und Methoden Systematische Literaturrecherche in folgenden Online-Datenbanken: PubMed, MEDLINE, Thompson Reuters Web of Science und SPIE nach den Suchbegriffen: sentinel node, sentinel node biopsy, head and neck squamous cell carcinoma, near-infrared imaging, indocyanine green, icg. Bewertung der wissenschaftlichen Relevanz der Arbeiten nach festgelegten Kriterien.

Ergebnisse Es wurden Arbeiten in Bezug auf die klinische Anwendung, die klinische Befunderhebung, die Identifikationsrate und die Falsch-Negativ-Rate analysiert. Die Identifikationsrate des SLN liegt bei 97–100 %, mit durchschnittlich 1,2–3,4 Fluoreszenz positiven Lymphknoten pro Untersuchung. Die Rate falsch-negativer Befunde variiert insgesamt zwischen 0 und 20 %.

Schlussfolgerungen In Zusammenschau der aktuell publizierten Ergebnisse verspricht die NIR-Bildgebung ein großes Potenzial, die Diagnostik des SLN bei Karzinomen im Bereich der Mundhöhle und des Pharynx zu verbessern. Vorteilhaft ist die einfache und schnelle Durchführung mit guter räumlicher Auflösung ohne Strahlenexposition.

Abstract

Background Near-infrared fluorescence (NIR) imaging is a new technique for intraoperative identification of sentinel lymph nodes (SLN). It has shown promising results in several surgical specialties. This article reviews the current study situation of NIR SLN diagnosis of head and neck malignancy.

Material and methods Systematic literature search in the following online databases: PubMed, MEDLINE, Thompson Reuters Web of Science, SPIE for the search terms: sentinel node, sentinel node biopsy, head and neck squamous cell carcinoma, near-infrared imaging, indocyanine green, icg. Evaluation of scientific relevance of papers according to established criteria.

Results Studies were analyzed in terms of clinical application, clinical reporting, identification rate, and false-negative rate. The identification rate of SLN is 97–100 %, with an average of 1.2–3.4 fluorescence positive lymph nodes per examination. The overall false-negative rate varies between 0 and 20 %.

Conclusions In the synopsis of the currently published results, NIR imaging promises the great potential to improve the diagnosis of SLN in carcinomas of the oral cavity and pharynx. A simple and fast procedure with high spatial resolution and without radiation exposure is beneficial.

Schlüsselwörter

Sentinel-Biopsie - Neck-Dissection - Fluoreszenz - ICG - Nahinfrarot - Kopf-Hals-Malignom

Key words

sentinel biopsy - neck dissection - fluorescence - ICG - near-infrared - head and neck malignancy

Publikationsverlauf

Eingereicht: 26. Januar 2021

Angenommen: 10. Mai 2021

Artikel online veröffentlicht:
28. Mai 2021

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