Sentinel lymph node biopsy (SLNB) uses a dual technique in most centres. Which combination of agents provides the highest sentinel node identification rate?
- A Patent blue dye combined with technetium-99m nanocolloid ✓
- B Patent blue dye alone
- C Technetium-99m labelled nanocolloid alone
- D Indocyanine green (ICG) alone with near-infrared imaging
Explanation
The combination of patent blue dye (visual identification) and technetium-99m labelled nanocolloid (preoperative lymphoscintigraphy and intraoperative gamma probe detection) provides the highest sentinel node identification rates (>95%) and lowest false-negative rates compared to either technique alone. This dual localisation technique is the current standard. Indocyanine green with near-infrared fluorescence is emerging as an alternative with comparable efficacy and without radiation exposure, but combined blue dye + isotope remains the most widely validated approach (ALMANAC trial).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.