Detection rates of sentinel lymph node in vulvar cancer using the new protocol with indocyanine-green fluorescence: Time to abandon both blue dye as well as 99mTc-labeled colloid lymphoscintigraphy protocols?

With great deal of interest, we read the article entitled: “Comparison of ICG-NIR with blue dye and technetium for the detection of sentinel lymph nodes in vulvar cancer” by Rundle et al. [1]. The authors present a 92% detection rate of sentinel lymph nodes in vulvar cancer patients using a new protocol with the combination of ICG-NIR and 99mTc-nanocolloid compared to 69% with the older protocol of blue dye combined with 99mTc-nanocolloid. Based on their findings, abandonment of routine use of blue dye is proposed [1].