Diagnostic accuracy of combined optical- and radio-guided SNB for neck staging of oral squamous cell carcinoma lesions in the anterior oral cavity

Eur Arch Otorhinolaryngol. 2023 Jul;280(7):3393-3403. doi: 10.1007/s00405-023-07939-5. Epub 2023 Apr 3.

Abstract

Purpose: The purpose was to investigate the diagnostic performance of bimodal optical and radio-guided sentinel node biopsy (SNB) for oral squamous cell carcinoma (OSCC) sub-sites in the anterior oral cavity.

Methods: Prospective study of 50 consecutive patients with cN0 OSCC scheduled for SNB was injected with the tracer complex Tc99m:ICG:Nacocoll. A near-infrared camera was applied for optical SN detection. Endpoints were modality for intraoperative SN detection and false omission rate at follow-up.

Results: In all patients, a SN could be detected. In 12/50 (24%) of cases, the SPECT/CT showed no focus in level 1, but intraoperatively a SN in level 1 was optically detected. In 22/50 cases (44%), an additional SN was identified only due to the optical imaging. At follow-up, the false omission rate was 0%.

Conclusion: Optical imaging appears to be an effective tool to allow real-time SN identification comprising level 1 unaffected by possible interference of radiation site from the injection.

Keywords: Indocyanine green; Near-infrared optical imaging; Neck metastasis; Oral squamous cell carcinoma; Sentinel node biopsy.

MeSH terms

  • Carcinoma, Squamous Cell* / diagnostic imaging
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / surgery
  • Head and Neck Neoplasms* / pathology
  • Humans
  • Mouth Neoplasms* / pathology
  • Neoplasm Staging
  • Prospective Studies
  • Sentinel Lymph Node Biopsy / methods
  • Squamous Cell Carcinoma of Head and Neck / pathology