Vyas et al 2025 — ICG-only SLNB in Head and Neck Melanoma
Key findings
Prospective cohort, July 2023–Nov 2024, 67 patients / 182 nodes, three arms: ICG-only (Group A, 29 patients), ICG+radiocolloid (Group B), radiocolloid+blue dye (Group C).
- Where each technique was used: ICG 100%, radiocolloid 85%, blue dye 80% node detection
- Nodal metastases: ICG 100%, radiocolloid 89%, blue dye 50%
- 38% of biopsied nodes (42/110) were not identified on preoperative SPECT-CT; 3 of the 12 metastatic nodes overall (7.1%) were among those SPECT-CT missed
- Learning curve observed: false-positive rate improved between first and last 10 ICG-only cases
My take
This is the main article underpinning the case — a good supporting example of ICG as the most effective lymph node mapping technique. See Correspondence Exchange on Vyas et al 2025 for the published critique and author reply, and Open Questions - ICG Alone vs Complementary Framing for how this thesis applies (or doesn’t cleanly apply) to our own case.