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. 2025 Jul;32(4):834-840.
doi: 10.1007/s12282-025-01712-8. Epub 2025 May 10.

Detection capability of the Medical Imaging Projection System for sentinel lymph node biopsy in patients with breast cancer with and without neoadjuvant chemotherapy: a retrospective study

Marin Taguchi  1   2 , Masahiro Takada  3 , He Jiaxi  1 , Yukiko Fukui  1 , Hanako Shimizu  1 , Ayane Yamaguchi  1 , Kosuke Kawaguchi  1   4 , Masahiro Kawashima  1 , Nobuko Kawaguchi-Sakita  5 , Masakazu Toi  6
Affiliations

Detection capability of the Medical Imaging Projection System for sentinel lymph node biopsy in patients with breast cancer with and without neoadjuvant chemotherapy: a retrospective study

Marin Taguchi et al. Breast Cancer. 2025 Jul.

Abstract

Background: The Medical Imaging Projection System (MIPS) projects fluorescence ICG images on the surgical field. In this study, we aimed to assess sentinel lymph node (SLN) identification by the MIPS in patients with and without neoadjuvant chemotherapy (NAC) administration and compare the utility of the MIPS with the radioisotope (RI) method.

Methods: We retrospectively reviewed medical records of patients with primary breast cancer who underwent SLN biopsy using the MIPS at Kyoto University Hospital between April 2020 and December 2024. The primary endpoint was the identification rate of SLNs. The secondary endpoints included the number of positive SLNs and SLNs detected per patient.

Results: The analysis included 470 procedures (448 patients), of which 56 (11.9%) were conducted after NAC. The identification rate of SLNs by the MIPS was 99.6% (95% confidence interval [CI], 98.5-99.9) in all procedures and 98.2% (95% CI, 90.6-99.7) after NAC. The median number of SLNs identified per patient was 3 (range, 2-4) by the MIPS and 2 (range, 1-3) by the RI method (P < 0.001). No significant difference was observed in the number of SLNs between patients who received NAC and those who did not (3 vs 3, P = 0.84). Seventy-eight positive SLNs were excised, all of which were accurately identified by the MIPS.

Conclusions: This study suggested that the identification rate of SLNs by the MIPS was high regardless of the presence or absence of preceding systemic chemotherapy.

Keywords: Breast cancer; Indocyanine green fluorescence method; Neoadjuvant chemotherapy; Projection mapping; Sentinel lymph node biopsy.

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Conflict of interest statement

Declarations. Conflict of interest: Masahiro Takada received a research grant from Yakult Honsha, Guardant Health Japan and Medbis, and received lecture fees from Daiichi Sankyo, AstraZeneca, Taiho, Eli-Lilly, MSD, Pfizer, Eisai, Chugai, Devicor Medical Japan, Kyowa Kirin, and Mitaka Kohki; Masahiro Kawashima received a research grant from Nippon Kayaku, Kyowa Kirin and Advalife Science. He received lecture fees from Guardant Health AMEA, Chugai, Daiichi-Sankyo, Pfizer, Eisai, Taiho and Devicor Medical Japan; Nobuko Kawaguchi-Sakita received personal fees from Chugai, Kyowa Kirin, Eisai, Zene, Daiichi-Sankyo, Taiho, Astra Zeneca, Yakult, PRiME-R, HUG, IHC, NTT, CANNON Medical and Meiji Seika Pharma; Masakazu Toi received a research grant from Chugai, Takeda, Pfizer, Taiho, JBCRG assoc., KBCRN assoc., Eisai, Eli-Lilly and companies, Daiichi-Sankyo, AstraZeneca, Astellas, Shimadzu, Yakult, Nippon Kayaku, AFI technology, Luxonus, Shionogi, GL Science and Sanwa Shurui. He has funding from Chugai, Takeda, Pfizer, Kyowa-Kirin, Taiho, Eisai, Daiichi-Sankyo, AstraZeneca, Eli Lilly and companies, MSD, Exact Science, Novartis, Shimadzu, Yakult, Nippon Kayaku, Devicore Medical Japan and Sysmex as compensation for Lecture honoraria or lecture chairs. He has funding from Daiichi-Sankyo, Eli Lilly and companies, BMS, Athenex Oncology, Bertis, Terumo, Kansai Medical Net for Advisory board. He has funding from British Journal of Cancer, Scientific Reports, Breast Cancer Research and Treatment, Cancer Science, Asian Journal of Surgery, and Asian Journal of Breast Surgery for Associate editor; Marin Taguchi, He Jiaxi, Yukiko Fukui, Hanako Shimizu, Ayane Yamaguchi and Kosuke Kawaguchi have no conflict of interest. Research involving human participants: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the institutional review board of Kyoto University Hospital (approval no.: R4913). Informed consent: Formal consent was not required owing to the retrospective nature of the study.

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