INDOCYANINE GREEN FLUORESCENCE IN ONCOLOGIC SURGERY: A CRITICAL REVIEW OF SENTINEL LYMPH NODE MAPPING AND TUMOR MARGIN ASSESSMENT

Amelia Kędziora; Kinga Haduch; Zuzanna Michalska; Olga Chorąży; Aleksandra Stańczyk; Anna Łęczycka; Kinga Stefanska; Nicole Aleksandra Ordyczyńska-Mardyła; Izabela Zuzanna Stranz; Joanna Strzelczyk; Iga Suchta

doi:10.31435/ijitss.3(51).2026.6158

Authors

Amelia Kędziora University of Warmia and Mazury in Olsztyn, Poland https://orcid.org/0009-0001-8883-4370
Kinga Haduch University Hospital in Kraków, Poland https://orcid.org/0009-0004-4853-9395
Zuzanna Michalska Clinical Hospital of the Ministry of Internal Affairs and Administration with the Warmia-Mazury Oncology Centre in Olsztyn, Poland https://orcid.org/0009-0005-8775-102X
Olga Chorąży Independent Public Healthcare Center Myślenice, Poland https://orcid.org/0009-0001-3094-2299
Aleksandra Stańczyk Clinical Hospital of the Ministry of Internal Affairs and Administration with the Warmia-Mazury Oncology Centre in Olsztyn, Poland https://orcid.org/0009-0000-2356-7841
Anna Łęczycka Independent Public Health Care Facility of the Ministry of Internal Affairs and Administration in Gdańsk, Poland https://orcid.org/0009-0004-9068-5222
Kinga Stefanska University of Warmia and Mazury in Olsztyn, Poland https://orcid.org/0009-0006-4423-3828
Nicole Aleksandra Ordyczyńska-Mardyła District Hospital in Chrzanów, Poland https://orcid.org/0009-0007-1502-8291
Izabela Zuzanna Stranz Ludwik Rydygier Provincial Hospital in Toruń, Poland https://orcid.org/0009-0002-3689-0132
Joanna Strzelczyk Nicolaus Copernicus Provincial Multispecialty Center for Oncology and Traumatology in Łódź, Poland https://orcid.org/0009-0006-8212-9431
Iga Suchta District Hospital in Proszowice, Poland https://orcid.org/0009-0005-5837-5790

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6158

Keywords:

Indocyanine Green (ICG), Fluorescence-Guided Surgery, Surgical Oncology, Sentinel Lymph Node Mapping, Tumor Margin Assessment, Near-Infrared Fluorescence Imaging

Abstract

Objective: To critically evaluate current evidence regarding the clinical utility, effectiveness, and limitations of indocyanine green (ICG) fluorescence imaging in oncologic surgery, with particular emphasis on sentinel lymph node mapping and tumor margin assessment.

Methods: A narrative literature review was conducted using the PubMed database. Studies published between 2013 and 2025 were analyzed, including clinical studies, randomized trials, systematic reviews, meta-analyses, consensus statements, and methodological papers addressing oncologic applications of ICG fluorescence imaging.

Results: Strong evidence supports the use of ICG fluorescence imaging in sentinel lymph node mapping across colorectal, gastric, breast, and gynecologic cancers. The technique improves visualization of lymphatic pathways and facilitates intraoperative navigation. Evidence regarding tumor margin assessment remains heterogeneous, with diagnostic performance limited by the non-specific accumulation of ICG and variability among imaging protocols.

Conclusions: ICG fluorescence imaging is an effective and increasingly valuable tool in oncologic surgery, particularly for sentinel lymph node mapping. However, its role in tumor margin assessment remains less established. Further standardization and development of tumor-specific fluorescence agents are required to optimize clinical applications.

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