IC-Flow™ Indications | Oncology

Flourescent Dye-Guided SLN Detection

Flourescent dye-guided SLN detection
SLN detection with IC-Flow™. Universitätsklinikum Tübingen

The primary application of the IC-Flow in oncology is  the detection of Sentinel Lymph nodes (SLNs), especially in breast cancer. Malignant tumors (cancer) can spread their cells via blood or lymph vessels, which leads to growth of metastases. In case of lymphatic spread, tumor cells accumulate in lymph nodes.

Examination of the SLN can reveal whether a tumor has already spread and is very important for determining the further treatment of the patient. This diagnostic method is a real-time technique allowing the visualization of  SLNs within short time period, without the use of radioisotopes. 1-13




Published Studies On Flourescent Dye-Guided SLN Detection

No. of patients Blue dye Technetium-99m Fluorescent dye
SLN identification by visual observation gamma probe fluorescenceguided camera
Tagay (2008) 11 25 92% 100%
Hojo (2010) 4 141 92,9% (105/113) 100% (28/28) 99,3% (140/141)
Abe (2011) 1 128 66% 100%
Polom (2012) 9 49 100% 98%
Wishart (2012) 13 100 95% 77,6% 100%
Ballardni (2013) 3 134 93,9% 99,6%

Detection Procedure with IC-Flow Imaging System

Fig. 1-8 SLN detection procedure with IC-Flow.AGAPLESION Markus Krankenhaus, Frankfurt, Germany


  1. Abe H. et al. Indocyanine Green Fluorescence Imaging System for Sentinel Lymph Node Biopsies in Early Breast Cancer Patients. Surg. Today (2011);41(2):p.197–202.
  2. Aoyama K. et al. Sentinel Lymph Node Biopsy for Breast Cancer Patients Using Fluorescence Navigation with Indocyanine Green. World J Surg Oncol (2011);9:p.157.
  3. Ballardini B. et al. The indocyanine green method is equivalent to the 99mTc-labeled radiotracer method for identifying the sentinel node in breast cancer: A concordance and validation study. Eur J Surg Oncol (2013);39(12):p.1332-6.
  4. Hojo T. et al. Evaluation of Sentinel node biopsy by combined fluorescent and dye method and lymph flow for breast cancer. Breast (2010);19(3):p. 210-3.
  5. Hirche C. et al. High Rate of Solitary Sentinel Node Metastases Identification by Fluorescence-Guided Lymphatic Imaging in Breast Cancer. J. Surg. Oncol. (2011);105(2):p.162-6.
  6. Kitai T. et al. Fluorescence Navigation with Indocyanine Green for Detecting Sentinel Lymph Nodes in Breast Cancer. Breast Cancer (2005);12(3):p. 211-5.
  7. Mihara M. et al. Scarless lymphatic venous anastomosis for latent and early-stage lymphoedema using indocyanine green lymphography and non-invasive instruments for visualising subcutaneous vein. J Plas Recon (2012);65(11):p. 1551-8.
  1. Murawa D. et al. Sentinel lymph node biopsy in breast cancer guided by indocyanine green fluorescence. Br J Surg (2009);96(11):p. 1289-94.
  2. Polom K. et al. Breast cancer sentinel lymph node mapping using near infrared guided indocyanine green and indocyanine green-human serum albumin in comparison with gamma emitting radioactive colloid tracer. Eur J Surg Oncol (2012);38:2,p. 137-142.
  3. Sugie T. et al. A Novel Method for Sentinel Lymph Node Bopsy by Indocyanine Green Fluorescence Technique in Breast Cancer. Cancers (2010);2(2):p. 713-20.
  4. Tagaya N. et al. Intraoperative identification of sentinel lymph nodes by near-infrared fluorescence imaging in patients with breast cancer. Am J Surg (2008);195(6):p. 850-3.
  5. Veronesi U. et al. A Randomized Comparison of Sentinel-Node Biopsy with Routine Axillary Dissection in Breast Cancer. N Engl J Med (2003);349(6):p. 546-53.
  6. Wishart G. et al. A feasibility study (ICG-10) of indocyanine green (ICG) fluorescence mapping for sentinel lymph node detection in early breast cancer. Eur J Surg Oncol (2012);38(8):p. 651-6.