Application Of Indocyanine Green Coaxial Fluorescence Projective Imaging For Sentinel Lymph Node Biopsy In Acral Malignant Melanoma

Objective:To observe the tracing effect of indocyanine green(ICG)coaxial fluorescence projection imaging system(CFPI)and methylene blue(MB)staining in sentinel lymph node biopsy(SLNB)of malignant melanoma(AM),and explore the clinical application value of ICG coaxial fluorescence projection technology in sentinel lymph node biopsy of malignant melanoma.Methods:Data of patients with acral malignant melanoma requiring SLNB diagnosed in the First Affiliated Hospital of University of Science and Technology of China from April 2020 to October 2022 were retrospectively analyzed.Both ICG and MB were injected intraoperatively to trace the sentinel lymph node(SLN),and SLNB was performed according to fluorescent labeling.Numbers of SLN and metastatic SLN deteted by ICG,MB,ICG combined with MB during operation were recorded.Statistical analysis was performed using Graphpad Prism 6 software,and the detected number of SLN was expressed as x±s,and paired t-test was performed.The detection rate of SLN was expressed by(n)%and χ2 test was used.P<0.05 was considered statistically significant.Results:A total of 21 patients were included,and 62 SLNs were detected,among which 58(93.5%)were detected by ICG,41(66.1%)by MB,and 62(100.0%)by ICG combined with MB,respectively.The detection rate of ICG was significantly higher than that of MB,with statistical significance(χ2=22.34,P=0.001).The detected numbers of SLN by ICG,MB,ICG combined with MB were(2.76±0.23),(1.95±0.21)and(2.95±0.25)per person,respectively.ICG was significantly more than MB,and the difference was statistically significant(t=2.60,P=0.013).A total of 10 metastatic SLNs were detected,of which 10 were detected by ICG(100%),7 were detected by MB(70%),and 10 were detected by ICG combined with MB(100%).Conclusion:Compared with MB,ICG-CFPI showed better performance in SLNB,and ICG combined with MB showed better performance than ICG alone.