Posters
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Student
Academic Level (Author 1)
Medical Student
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Cancer and Immunology
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Sentinel lymph node biopsy (SLNB) is crucial for staging melanoma and determining metastasis. Indocyanine Green (ICG) has emerged as a promising near-infrared fluorescence (NIF) mapping technique. Recent advancements in NIF imaging systems, specifically with color-segmented fluorescence (termed “Red Capping”), may enhance the detection of positive sentinel lymph nodes. This study aims to compare node positivity rates between ICG alone and ICG combined with Red Capping in melanoma patients undergoing SLNB.
Methods: A retrospective review of a prospectively maintained, Institutional Review Board-approved database was performed for melanoma patients who underwent SLNB between July 2018 and September 2024. All patients received standard-of-care SLNB with a radiotracer. The study group (n=23) received ICG with Red Capping fluorescence, while the control group (n=47) received ICG alone. Clinical, pathological, and nodal data were analyzed, with SLN identification by Red Capping confirmed via radiotracer-based gamma count reductions (>90%).
Results: A total of 70 patients met the study criteria (median age 67; 49% male, 51% female). Both the ICG-only and Red Capping groups achieved a 100% SLN detection rate as confirmed by radiotracer. The Red Capping group demonstrated a higher node positivity rate, with 26.1% of nodes testing positive compared to 19.1% in the ICG-only group; however, this difference did not reach statistical significance. Tumor characteristics, including ulceration, thickness, and staging—were comparable between groups. Notably, the Red Capping group exhibited a higher proportion of aggressive tumor features, with a mitotic rate >7% observed in 23.8% of patients versus 15.4% in the ICG-only group.
Conclusions: Color-segmented fluorescence (“Red Capping”) shows promise as a sensitive adjunct in the detection of positive sentinel lymph nodes in melanoma patients. Although the observed difference in node positivity rates between the groups did not achieve statistical significance, the trend suggests potential clinical benefit. Further research with larger sample sizes and longer follow-up is warranted to confirm these findings and to evaluate the technique’s role as a primary mapping tool.
Presentation Type
Poster
Recommended Citation
Vyas, Siddarth; Obaid, Ala; Davis, Catherine H.; and Preskitt, John T., "Color Segmented Fluorescence (“Red Cap”) Sentinel Lymph Node Biopsy in Patients with Melanoma: Can it Increase Sensitivity in Sentinel Lymph Node Detection?" (2025). Research Colloquium. 92.
https://scholarworks.utrgv.edu/colloquium/2025/posters/92
Included in
Color Segmented Fluorescence (“Red Cap”) Sentinel Lymph Node Biopsy in Patients with Melanoma: Can it Increase Sensitivity in Sentinel Lymph Node Detection?
Background: Sentinel lymph node biopsy (SLNB) is crucial for staging melanoma and determining metastasis. Indocyanine Green (ICG) has emerged as a promising near-infrared fluorescence (NIF) mapping technique. Recent advancements in NIF imaging systems, specifically with color-segmented fluorescence (termed “Red Capping”), may enhance the detection of positive sentinel lymph nodes. This study aims to compare node positivity rates between ICG alone and ICG combined with Red Capping in melanoma patients undergoing SLNB.
Methods: A retrospective review of a prospectively maintained, Institutional Review Board-approved database was performed for melanoma patients who underwent SLNB between July 2018 and September 2024. All patients received standard-of-care SLNB with a radiotracer. The study group (n=23) received ICG with Red Capping fluorescence, while the control group (n=47) received ICG alone. Clinical, pathological, and nodal data were analyzed, with SLN identification by Red Capping confirmed via radiotracer-based gamma count reductions (>90%).
Results: A total of 70 patients met the study criteria (median age 67; 49% male, 51% female). Both the ICG-only and Red Capping groups achieved a 100% SLN detection rate as confirmed by radiotracer. The Red Capping group demonstrated a higher node positivity rate, with 26.1% of nodes testing positive compared to 19.1% in the ICG-only group; however, this difference did not reach statistical significance. Tumor characteristics, including ulceration, thickness, and staging—were comparable between groups. Notably, the Red Capping group exhibited a higher proportion of aggressive tumor features, with a mitotic rate >7% observed in 23.8% of patients versus 15.4% in the ICG-only group.
Conclusions: Color-segmented fluorescence (“Red Capping”) shows promise as a sensitive adjunct in the detection of positive sentinel lymph nodes in melanoma patients. Although the observed difference in node positivity rates between the groups did not achieve statistical significance, the trend suggests potential clinical benefit. Further research with larger sample sizes and longer follow-up is warranted to confirm these findings and to evaluate the technique’s role as a primary mapping tool.
