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Indocyanine green + sulfan blue is a combination of two diagnostic dyes used primarily for sentinel lymph node mapping in surgical oncology, especially breast cancer. Indocyanine green (ICG) is a water-soluble tricarbocyanine dye that fluoresces under near-infrared light, allowing real-time visualization of lymphatic drainage pathways and sentinel nodes during surgery. Sulfan blue (also known as Patent Blue V or isosulfan blue in some regions) is a visible dye that stains lymphatic vessels and nodes bright blue for direct visual identification. The combination leverages the strengths of both agents—ICG’s fluorescence imaging with NIR cameras and the visible staining from sulfan blue—to improve detection rates and reduce false negatives compared to either agent alone. This dual-tracer approach provides an alternative to radioisotope-based mapping methods, particularly useful where nuclear medicine facilities are unavailable or undesirable due to regulatory or logistical reasons[1][2][5]. Both agents are generally well-tolerated but can cause rare allergic reactions; caution should be exercised in patients with known dye allergies.
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