A new fluorescenttargeting tracer contrasts dual tracers in sentinel lymph node biopsy of breast cancer

Figures & data

Table 1. Instruments and reagents.

	Specifications/models	Provider
Radioisotope	^99mTc-labeled sulfur colloid	Beijing New Kostar company, prepared by nuclear medicine department of Shandong Cancer Hospital (Beijing, China)
Dye	Methylene blue 20 mg 2 ml	Jichuan Pharmaceutical Group Co., Ltd (Jiangsu, China)
Indocyanine green	25 mg	Dandong Yichuang Pharma, Ltd (Dandong, China)
Rituximab	100 mg	Shanghai Roche Pharmaceuticals (Shanghai, China)
Near-infrared fluorescence imaging system	MI-1 fluorescence imaging system	Mingde Biotech, Ltd (Hebei, China)
Gamma probe detection	Neoprobe, Neo2000 gamma detection system	Johnson and Johnson (Shanghai, China)

Table 2. Characteristics of indocyanine green–rituximab dose-climbing test cases (n = 50).

Characteristic	A	B	C	D	E	p-value
n	10	10	10	10	10
Age						0.757
<40 years	2	1	2	3	1
From 40 to approximately 59 years	7	7	6	6	5
>59 years	1	2	2	1	4
Tumor size (cm)	2.283	2.018	2.267	2.152	2.087	0.341
Tumor site						0.872
Upper outer quadrant	5	6	5	5	4
Lower outer quadrant	1	2	1	1	1
Upper inner quadrant	2	1	2	1	0
Lower inner quadrant	1	1	1	1	4
Central	1	1	1	2	1
Histological grading						0.315
Carcinoma in situ	4	1	1	3	1
I	0	0	0	0	1
II	3	6	7	7	7
III	3	3	2	0	1

Table 3. Characteristics of indocyanine green–rituximab verification test cases (n = 110).

Characteristic	n (%)
Pathology:   Noninvasive carcinoma   Ductal   Lobular   Others	16 (14.5) 86 (78.2) 1 (0.9) 7 (6.3)
Tumor site:   Upper outer quadrant   Lower outer quadrant   Upper inner quadrant   Lower inner quadrant   Central	69 (62.7) 13 (11.8) 19 (17.3) 5 (4.5) 4 (3.6)
BMI:   BMI<18.5   18.5≤BMI<25   25≤BMI<30   30≤BMI	3 (2.7) 70 (63.6) 29 (26.4) 8 (7.3)
Mode of operation:   Mastectomy   Breast conserving surgery   Prosthesis implantation	65 (59.1) 41 (37.3) 4 (3.6)
Tumor staging:   Ductal carcinoma in situ   T1   T2   T3	16 (14.5) 63 (57.3) 29 (26.4) 2 (1.8)

Figure 1. The development of five groups at different doses.

ICG-Rit: Indocyanine

Figure 2. Different gray values of lymph nodes in ICG-Rit imaging.

The gray values were 254 (A), 226 (B) and 209 (C).

ICG-Rit: Indocyanine green–rituximab.

Table 4. Detection rate of sentinel lymph node by indocyanine green–rituximab and combined method.

Number	Combined +	Combined -	Total ICG	p-value
ICG+	28	0	28	≤ 0.001
ICG-	1	78	79
Total combined	29	78	107

Combined tracer: methylene blue and ^99mTc-SC.

ICG: Indocyanine green.