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ICG Dosing and Timing for Breast Cancer Surgery

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is increasingly used in breast cancer surgery to visualize lymphatic drainage, identify sentinel lymph nodes, and assess tissue perfusion during reconstruction. Proper dosing and timing of ICG administration are essential to achieve optimal near-infrared fluorescence imaging during the procedure.

    This dosing and timing chart provides practical guidance for ICG use in breast cancer surgery, including recommended injection techniques, dosage ranges, and expected fluorescence detection times for sentinel lymph node mapping and breast reconstruction perfusion assessment.
  • Sección:
    • Title: Dosing & Timing Chart, Tabla:
      • Columna1:

        Purpose:

        , Contenido:

        Visualize lymphatic drainage & sentinel lymph node

      • Columna1:

        Injection Type: 

        , Contenido:

        Other

      • Columna1:

        Description:

        , Contenido:

        Dye administration should be subcutaneous into periareolar region of each quadrant.

      • Columna1:

        Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL): 

        , Contenido:

        Yes

      • Columna1:

        Requires Flush with Sterile Water: 

        , Contenido:

        No

      • Columna1:

        Proposed Dosage: 

        , Contenido:

        1 mL

      • Columna1:

        Injection Time: 

        , Contenido:

        At start of procedure.

      • Columna1:

        First Indocyanine Green Detection: 

        , Contenido:

        Five to 10 minutes after administration

      • Columna1:

        Indocyanine Green Duration: 

        , Contenido:

        Stable during surgery. Slowly diffuses through lymphatics

      • Columna1:

        Camera Requirements (handheld device, laparoscope or both): 

        , Contenido:

        Handheld

      • Columna1:

        Tips & Tricks: 

        , Contenido:

        Total 4 mL (1 mL per periareolar quadrant). Gentle, circular motion massaging can be performed to distribute dye.

Written on .

ICG Dosing and Timing for Breast Reconstruction

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is widely used in breast reconstruction to assess perfusion of mastectomy skin flaps and support intraoperative decision-making. Near-infrared fluorescence angiography allows surgeons to visualize real-time blood flow and identify areas at risk of ischemia during reconstructive procedures.

    This dosing and timing chart outlines recommended ICG administration for breast reconstruction, including intravenous injection protocols, dosage guidance, and expected fluorescence detection times. These parameters help optimize intraoperative perfusion assessment and improve surgical outcomes during reconstructive breast surgery.
  • Sección:
    • Title: Dosing & Timing Chart, Tabla:
      • Columna1:

        Purpose:

        , Contenido:

        Mastectomy skin flaps perfusion

      • Columna1:

        Injection Type: 

        , Contenido:

        Intravenous

      • Columna1:

        Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL): 

        , Contenido:

        Yes

      • Columna1:

        Requires Flush with Sterile Water: 

        , Contenido:

        Yes

      • Columna1:

        Proposed Dosage: 

        , Contenido:

        1 mL

      • Columna1:

        Injection Time: 

        , Contenido:

        During skin flap manipulation and reconstruction.

      • Columna1:

        First Indocyanine Green Detection: 

        , Contenido:

        30–60 seconds after administration

      • Columna1:

        Indocyanine Green Duration: 

        , Contenido:

        60 s–3 mins

      • Columna1:

        Camera Requirements (handheld device, laparoscope or both): 

        , Contenido:

        Handheld

      • Columna1:

        Tips & Tricks: 

        , Contenido:

        Adjunct to clinical assessment and surgical symmetry.

Written on .

ICG Dosing and Timing for Cervical and Endometrial Cancer Surgery

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is widely used in gynecologic oncology to visualize lymphatic drainage and identify sentinel lymph nodes during cervical and endometrial cancer surgery. Proper dosing, injection site, and timing of ICG administration are critical to achieve reliable near-infrared fluorescence imaging and accurate lymphatic mapping.

    This dosing guide outlines recommended ICG administration techniques for cervical and endometrial cancer procedures, including injection into the cervical submucosa and deep stromal tissue, dosage per quadrant, and expected fluorescence detection during sentinel lymph node mapping.
  • Sección:
    • Title: Dosing & Timing Chart, Tabla:
      • Columna1:

        Purpose:

        , Contenido:

        Visualize lymphatic drainage & sentinel lymph node

      • Columna1:

        Injection Type: 

        , Contenido:

        Other

      • Columna1:

        Description:

        , Contenido:

        Administration of the dye should be performed at the level of the cervical submucosa, deep into the stroma. The dye should be distributed into 4 cervical quadrants.

      • Columna1:

        Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL): 

        , Contenido:

        Yes

      • Columna1:

        Requires Flush with Sterile Water: 

        , Contenido:

        No

      • Columna1:

        Proposed Dosage: 

        , Contenido:

        1 mL

      • Columna1:

        Injection Time: 

        , Contenido:

        Prior to dissection & insertion of uterine manipulator

      • Columna1:

        First Indocyanine Green Detection: 

        , Contenido:

        At start of procedure

      • Columna1:

        Indocyanine Green Duration: 

        , Contenido:

        Stable during surgery. Slowly diffuses through lymphatics

      • Columna1:

        Camera Requirements (handheld device, laparoscope or both): 

        , Contenido:

        Both

      • Columna1:

        Tips & Tricks: 

        , Contenido:

        Total 4 mL (1 mL per cervical quadrant).

Written on .

ICG Dosing and Timing for Melanoma Surgery

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is used in melanoma surgery to visualize lymphatic drainage and support sentinel lymph node mapping. With near-infrared fluorescence imaging, surgeons can track lymphatic pathways in real time and identify sentinel lymph nodes to improve staging accuracy and surgical precision.

    This dosing chart outlines recommended ICG administration for melanoma procedures, including peritumoral injection techniques, dosage guidance, and expected fluorescence detection timing to optimize lymphatic mapping during fluorescence-guided melanoma surgery.
  • Sección:
    • Title: Dosing & Timing Chart, Contenido:

      *For 0.1 and 0.2 mL doses, utilize an insulin syringe to draw/administer volumen.

      , Tabla:
      • Columna1:

        Purpose:

        , Contenido:

        Sentinel lymph node identification

      • Columna1:

        Injection Type: 

        , Contenido:

        Other

      • Columna1:

        Description: 

        , Contenido:

        Administration should be intradermal, surrounding the area of interest.

      • Columna1:

        Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL): 

        , Contenido:

        Yes

      • Columna1:

        Requires Flush with Sterile Water: 

        , Contenido:

        No

      • Columna1:

        Proposed Dosage: 

        , Contenido:

        0.2 mL*

      • Columna1:

        Injection Time: 

        , Contenido:

        Five min prior to manipulation of skin site

      • Columna1:

        First Indocyanine Green Detection: 

        , Contenido:

        Five to 10 minutes after administration

      • Columna1:

        Indocyanine Green Duration: 

        , Contenido:

        Stable during surgery. Slowly diffuses through lymphatics

      • Columna1:

        Camera Requirements (handheld device, laparoscope or both): 

        , Contenido:

        Handheld

      • Columna1:

        Tips & Tricks: 

        , Contenido:

        Dye administration should be performed prior to local anesthesia administration

Written on .

ICG Dosing and Timing for Vulvar Cancer Surgery

  • Intro:

    Indocyanine green (ICG) fluorescence imaging is increasingly used in vulvar cancer surgery to visualize lymphatic drainage and identify sentinel lymph nodes. With near-infrared fluorescence imaging, surgeons can track lymphatic pathways in real time, improving sentinel lymph node detection and supporting more precise oncologic staging.

    This dosing chart provides guidance on recommended ICG administration for vulvar cancer procedures, including peritumoral injection techniques, dosage per injection site, and expected fluorescence detection timing to optimize sentinel lymph node mapping during fluorescence-guided surgery.
  • Sección:
    • Title: Dosing & Timing Chart, Tabla:
      • Columna1:

        Purpose:

        , Contenido:

        Visualize lymphatic drainage & sentinel lymph node

      • Columna1:

        Injection Type: 

        , Contenido:

        Other

      • Columna1:

        Description: 

        , Contenido:

        Peritumoral

      • Columna1:

        Dilution (25 mg in 10 mL of sterile water - 2.5mg/mL): 

        , Contenido:

        Yes

      • Columna1:

        Requires Flush with Sterile Water: 

        , Contenido:

        No

      • Columna1:

        Proposed Dosage: 

        , Contenido:

        1 mL

      • Columna1:

        Injection Time: 

        , Contenido:

        At start of procedure

      • Columna1:

        First Indocyanine Green Detection: 

        , Contenido:

        Minutes after administration

      • Columna1:

        Indocyanine Green Duration: 

        , Contenido:

        Stable during surgery. Slowly diffuses through lymphatics

      • Columna1:

        Camera Requirements (handheld device, laparoscope or both): 

        , Contenido:

        Both

      • Columna1:

        Tips & Tricks: 

        , Contenido:

        Total 4 mL (1 mL per tumor quadrant borders)

Written on .

Use of ICG Near-Infrared Fluorescent Dye in Confirming Successful Radiotracer Mapping and Sentinel Lymph Node Biopsy in Patients with Cutaneous Melanoma

  • Thumbnail 512x288:
  • Título del video: Use of ICG Near-Infrared Fluorescent Dye in Confirming Successful Radiotracer Mapping and Sentinel Lymph Node Biopsy in Patients with Cutaneous Melanoma
  • Chapter: Asia-Pacific Chapter
  • Speakers: Zamantha Franchezka G.P. San Lorenzo
  • Youtube/Vimeo link: https://vimeo.com/1107410543?share=copy

Written on .

Indocyanine Green Is a Safe and Effective Alternative to Radioisotope in Breast Cancer Sentinel Lymph Node Biopsy regardless of Patient Body Mass Index

  • Título completo del paper: Indocyanine Green Is a Safe and Effective Alternative to Radioisotope in Breast Cancer Sentinel Lymph Node Biopsy regardless of Patient Body Mass Index
  • Autores: Samantha Nga, Vassilis Pitsinisa, Emad H. Elseedawya, Douglas Browna, Alessio Vincia, Benjamin A. Jonesa, E. Jane Macaskilla
  • Fecha de publicacion: 2024-11-21
  • doi: https://doi.org/10.1159/000528155

Written on .

Oncological outcomes and locoregional recurrence after fluorescence guided surgery for axillary staging in early breast cancer: A single UK center experience

  • Título completo del paper: Oncological outcomes and locoregional recurrence after fluorescence guided surgery for axillary staging in early breast cancer: A single UK center experience
  • Autores: Rahul Kanitkar, Vassilis Pitsinis, Bushra Riaz, Alessio Vinci, Fiona Hogg, Lee B. Jordan
  • Fecha de publicacion: 2025-04-02
  • doi: https://doi.org/10.1016/j.ctarc.2025.100922

Written on .

Results of a Prospective Randomized Multicenter Study Comparing Indocyanine Green (ICG) Fluorescence Combined with a Standard Tracer Versus ICG Alone for Sentinel Lymph Node Biopsy in Early Breast Cancer: The INFLUENCE Trial

  • Título completo del paper: Results of a Prospective Randomized Multicenter Study Comparing Indocyanine Green (ICG) Fluorescence Combined with a Standard Tracer Versus ICG Alone for Sentinel Lymph Node Biopsy in Early Breast Cancer: The INFLUENCE Trial
  • Autores: Vassilis Pitsinis, Rahul Kanitkar, Alessio Vinci, Wen Ling Choong, John Benson
  • Fecha de publicacion: 2024-09-12
  • doi: https://doi.org/10.1245/s10434-024-16176-x