Duarte-Bateman et al — ICG SLNB Cohort of 1267 Melanoma Patients
Cleveland Clinic cohort, 1267 patients, comparing scintigraphy (LS), ICG+LS, and ICG-only.
Verified verbatim
Notably, ICG alone identified three sentinel nodes that radioactivity did not and would have otherwise been missed. These corresponded to three different patients, two of whom had only that node identified, making ICG solely responsible for their positive SLNB result. In these cases, ICG enabled accurate diagnosis and helped reduce the overall FNR of the procedure. The third patient had six nodes identified by both radioactivity and ICG, and one node identified by ICG alone. Although ICG did not change the staging in this instance, it facilitated the removal of a cancerous node that would have otherwise remained in situ, potentially leading to a recurrence. While this finding may not be statistically significant, it highlights the complementary strengths of the two techniques and supports their combined use to enhance nodal detection, thereby improving the accuracy of staging and treatment.
My take
The strongest existing precedent for “ICG catches what radioactivity misses” — directly supports the argument our case is making, at cohort scale rather than case-report scale.