Using the only FDA-approved near-infrared (NIR) fluorescent dye known as indocyanine green (ICG), our team has been able to identify tumors as well as their associated lymphatics in real time. The first lymph nodes that cancer spreads are called sentinel lymph nodes (SLN), and we are currently working on ways to identify these nodes intra-operatively for lung and esophageal cancers using the NIR technology. After identification, the SLN can be intensely analyzed for signs of cancer spread. This has important implications in the staging of these cancers and could potentially prevent patients from having to undergo a more extensive lymph node dissection if the SLN does not have cancer. In addition, the bNORMAL trial uses the novel navigational bronchoscopy to create a “road map” for injection of ICG in the airway to better mark the location of lung nodules intra-operatively and identify the corresponding SLN. Using this technology, we have become leaders in fluorescent image guided surgery.
Results of our work are published in the Journal of Thoracic and Cardiovascular Surgery.