Device Validation of Augmented-Reality ICG Fluorescence Imaging for Sentinel Lymph Node Detection in Breast Cancer
28 juni 2026 bijgewerkt door: Borislav Kondov, Ss. Cyril and Methodius University of Skopje
Validation of Augmented-Reality/Virtual-Reality Goggle-Based Near-Infrared Fluorescence Imaging for Sentinel Lymph Node Detection in Patients With Breast Cancer
This study evaluates how accurately augmented-reality goggles with indocyanine green (ICG) near-infrared fluorescence can identify sentinel (first-draining) lymph nodes during breast cancer surgery.
The goggles and ICG signal are used to mark candidate sentinel nodes, and an additional observer may record near-infrared images during the operation for device-performance assessment.
These imaging findings do not change the surgical procedure.
The candidate nodes and all removed tissue are examined by histopathology, which serves as the reference standard.
Two hundred patients undergoing breast cancer surgery will take part.
The study measures how well the goggle-based imaging detects nodes that contain cancer, compared with final pathology.
Studie Overzicht
Toestand
Nog niet aan het werven
Interventie / Behandeling
Gedetailleerde beschrijving
This is a prospective observational device-validation study in patients undergoing breast cancer surgery with axillary evaluation.
Augmented-reality goggle-based near-infrared fluorescence imaging with ICG is used to visualize and mark candidate sentinel lymph nodes.
Intraoperative near-infrared imaging may be performed by an observer who is not the operating surgeon, solely to assess device performance; observer findings are not communicated to the operating surgeon before wound closure and do not influence the operation.
All marked nodes and removed tissue undergo histopathology, which serves as the blinded reference standard.
Device performance is assessed on consecutive eligible patients within defined enrollment windows; for each near-infrared imaging device, sensitivity, specificity, positive and negative predictive value, and node-level ROC analysis are estimated against final histopathology, with confidence intervals accounting for clustering of nodes within patients.
The study is non-interventional: the imaging does not alter surgical management.
Studietype
Observationeel
Inschrijving (Geschat)
200
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studiecontact
- Naam: Borislav Kondov, MD
- Telefoonnummer: +38972539003
- E-mail: borislav.kondov@medf.ukim.edu.mk
Studie Contact Back-up
- Naam: Magdalena Bogdanovska Todorovska, MD
- Telefoonnummer: +389709602221
- E-mail: magdalena.todorovska@medf.ukim.edu.mk
Studie Locaties
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Skopje, Noord-Macedonië, 1000
- University Clinic for Thoracic and Vascular Surgery, Faculty of Medicine, UKIM
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Contact:
- Borislav Kondov, MD
- Telefoonnummer: +38972539003
- E-mail: borislav.kondov@medf.ukim.edu.mk
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Nee
Bemonsteringsmethode
Niet-waarschijnlijkheidssteekproef
Studie Bevolking
Patients with histologically proven breast cancer undergoing surgery with axillary lymph node evaluation at the participating center, enrolled consecutively.
Beschrijving
Inclusion Criteria:
- Histologically proven breast cancer
- Age 18 years or older
- Undergoing breast cancer surgery with sentinel lymph node evaluation and/or axillary lymph node dissection
- Provides written informed consent
Exclusion Criteria:
- Pregnancy
- Neoadjuvant chemotherapy
- Prior breast surgery
- Iodine or seafood allergy
- Indocyanine green (ICG) allergy
- Declines or is unable to provide informed consent
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
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Breast cancer patients undergoing surgery with AR-ICG node imaging
Patients undergoing breast cancer surgery in whom AR-ICG goggle-based near-infrared imaging is used to mark candidate sentinel nodes, with optional observer near-infrared imaging for device-performance assessment; histopathology is the reference standard.
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Augmented-reality goggle-based near-infrared fluorescence imaging with indocyanine green (ICG), used to visualize and mark candidate sentinel lymph nodes during breast cancer surgery.
Intraoperative near-infrared imaging may also be recorded by an observer for device-performance assessment.
Imaging does not alter surgical management; histopathology serves as the reference standard.
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Node-level diagnostic accuracy of AR-ICG fluorescence imaging versus histopathology
Tijdsspanne: From surgery to final histopathology (up to ~2 weeks after surgery)
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Sensitivity, specificity, positive and negative predictive value, and area under the ROC curve for goggle-based near-infrared fluorescence detection of tumor-positive lymph nodes, using final histopathology as the reference standard, with confidence intervals accounting for clustering of nodes within patients.
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From surgery to final histopathology (up to ~2 weeks after surgery)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Patient-level sentinel-node detection rate
Tijdsspanne: Final histopathology (up to approximately 2 weeks after surgery)
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Proportion of patients in whom at least one sentinel lymph node is identified by AR-ICG near-infrared fluorescence imaging.
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Final histopathology (up to approximately 2 weeks after surgery)
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Concordance of device-marked nodes with histopathology
Tijdsspanne: Final histopathology (up to approximately 2 weeks after surgery)
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Agreement between lymph nodes marked by AR-ICG fluorescence imaging and nodal status confirmed on final histopathology.
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Final histopathology (up to approximately 2 weeks after surgery)
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Per-device diagnostic performance across near-infrared imaging systems
Tijdsspanne: Through study completion (up to approximately 24 months)
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Sensitivity, specificity, positive predictive value, negative predictive value, and area under the ROC curve estimated separately for each near-infrared imaging device evaluated, using final histopathology as the reference standard, on consecutive eligible patients within defined enrollment windows.
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Through study completion (up to approximately 24 months)
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False-negative rate of AR-ICG fluorescence node detection
Tijdsspanne: Final histopathology (up to approximately 2 weeks after surgery)
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Proportion of pathology-confirmed tumor-positive lymph nodes not identified as fluorescent by AR-ICG imaging.
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Final histopathology (up to approximately 2 weeks after surgery)
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Number of candidate sentinel nodes identified per patient
Tijdsspanne: Intraoperative (day of surgery)
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Number of candidate sentinel lymph nodes marked by AR-ICG fluorescence imaging per patient (count).
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Intraoperative (day of surgery)
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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Giuliano AE, Ballman KV, McCall L, Beitsch PD, Brennan MB, Kelemen PR, Ollila DW, Hansen NM, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, Hunt KK, Morrow M. Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis: The ACOSOG Z0011 (Alliance) Randomized Clinical Trial. JAMA. 2017 Sep 12;318(10):918-926. doi: 10.1001/jama.2017.11470.
- Xiong X, Zheng LW, Ding Y, Chen YF, Cai YW, Wang LP, Huang L, Liu CC, Shao ZM, Yu KD. Breast cancer: pathogenesis and treatments. Signal Transduct Target Ther. 2025 Feb 19;10(1):49. doi: 10.1038/s41392-024-02108-4.
- Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE, Cataliotti L, Westenberg AH, Klinkenbijl JH, Orzalesi L, Bouma WH, van der Mijle HC, Nieuwenhuijzen GA, Veltkamp SC, Slaets L, Duez NJ, de Graaf PW, van Dalen T, Marinelli A, Rijna H, Snoj M, Bundred NJ, Merkus JW, Belkacemi Y, Petignat P, Schinagl DA, Coens C, Messina CG, Bogaerts J, Rutgers EJ. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol. 2014 Nov;15(12):1303-10. doi: 10.1016/S1470-2045(14)70460-7. Epub 2014 Oct 15.
- de Boniface J, Filtenborg Tvedskov T, Ryden L, Szulkin R, Reimer T, Kuhn T, Kontos M, Gentilini OD, Olofsson Bagge R, Sund M, Lundstedt D, Appelgren M, Ahlgren J, Norenstedt S, Celebioglu F, Sackey H, Scheel Andersen I, Hoyer U, Nyman PF, Vikhe Patil E, Wieslander E, Dahl Nissen H, Alkner S, Andersson Y, Offersen BV, Bergkvist L, Frisell J, Christiansen P; SENOMAC Trialists' Group; SENOMAC Trialists' Group. Omitting Axillary Dissection in Breast Cancer with Sentinel-Node Metastases. N Engl J Med. 2024 Apr 4;390(13):1163-1175. doi: 10.1056/NEJMoa2313487.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Geschat)
1 juli 2026
Primaire voltooiing (Geschat)
1 juli 2028
Studie voltooiing (Geschat)
31 december 2028
Studieregistratiedata
Eerst ingediend
28 juni 2026
Eerst ingediend dat voldeed aan de QC-criteria
28 juni 2026
Eerst geplaatst (Werkelijk)
6 juli 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
6 juli 2026
Laatste update ingediend die voldeed aan QC-criteria
28 juni 2026
Laatst geverifieerd
1 juni 2026
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- UKIM-AR-ICG-BREAST-VALID-2026
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
NEE
Beschrijving IPD-plan
This is a single-center observational device-validation study.
Individual participant data are not planned to be shared.
De-identified data may be made available from the principal investigator on reasonable request, subject to institutional approval.
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .