--- title: Training Teams for ICG-Guided Sentinel Node Mapping description: Explore the training strategies for surgical teams adopting ICG-guided sentinel lymph node mapping, enhancing confidence and workflow in breast cancer care. image: https://blog.quelimaging.com/hubfs/Breast_SLN_KS.jpg --- [Skip to content](https://blog.quelimaging.com/training-teams-for-icg-guided-sentinel-node-mapping#main-content) [![QUEL\_web\_logo-1](https://blog.quelimaging.com/hs-fs/hubfs/QUEL_web_logo-1.png?width=320&height=120&name=QUEL_web_logo-1.png)](https://shop.quelimaging.com/) - [Home](https://www.quelimaging.com/) - [Products](https://shop.quelimaging.com/) - [Blog](https://blog.quelimaging.com/) - [News](https://www.quelimaging.com/news) - [About](https://www.quelimaging.com/about) Open main navigation Close main navigation - [Home](https://www.quelimaging.com/) - [Products](https://shop.quelimaging.com/) - [Blog](https://blog.quelimaging.com/) - [News](https://www.quelimaging.com/news) - [About](https://www.quelimaging.com/about) - [Contact us](https://share.hsforms.com/1qlwaYoKVQvGnvWZt0GNGagcxyzv) [Contact us](https://share.hsforms.com/1qlwaYoKVQvGnvWZt0GNGagcxyzv) ### View of Field Oct 6, 2026, 10:58:14 AM # Training Teams for ICG-Guided Sentinel Node Mapping ![Picture of Ethan LaRochelle](https://app.hubspot.com/settings/avatar/925081a77283a399dbd145b49b251212) [Ethan LaRochelle](https://blog.quelimaging.com/author/ethan) Share: [facebook-f icon](http://www.facebook.com/share.php?u=https://blog.quelimaging.com/training-teams-for-icg-guided-sentinel-node-mapping) [linkedin-in icon](http://www.linkedin.com/shareArticle?mini=true&url=https://blog.quelimaging.com/training-teams-for-icg-guided-sentinel-node-mapping) [Twitter icon](https://twitter.com/intent/tweet?url=https://blog.quelimaging.com/training-teams-for-icg-guided-sentinel-node-mapping) [pinterest-p icon](http://pinterest.com/pin/create/link/?url=https://blog.quelimaging.com/training-teams-for-icg-guided-sentinel-node-mapping) [envelope icon](mailto:?body=https://blog.quelimaging.com/training-teams-for-icg-guided-sentinel-node-mapping) Regulatory approval of indocyanine green (ICG), for sentinel lymph node mapping in breast cancer is [expanding across Europe](https://diagnosticgreen.com/row/use-of-icg-in-breast-sln/). This gives more hospitals access to a nonradioactive alternative to conventional workflows. But approval is only the first step. Adoption depends on whether surgical teams have the knowledge, practical experience, and confidence to integrate a different tracer, imaging system, and workflow into patient care. At the [June 2026 ESSO–ISFGS short course](https://www.essoweb.org/courses-and-webinars/esso-isfgs-course-on-fluorescence-guided-surgery/) in Leiden, Dr. Annemiek Doeksen of St. Antonius Hospital shared practical lessons from implementing ICG-guided sentinel lymph node biopsy across hospitals. Her talk highlighted what her teams had to learn to use it reliably in the clinic. Injection timing, camera positioning, surgical field navigation, and interpreting the fluorescence images all needed refinement. The course complemented these clinical insights with hands-on work using ICG, fluorescence cameras, phantoms, and axillary models.![Breast\_SLN\_KS](https://blog.quelimaging.com/hs-fs/hubfs/Breast_SLN_KS.jpg?width=300&height=222&name=Breast_SLN_KS.jpg) As regulatory access grows, practical training is needed to accelerate clinical adoption. By combining foundational e-learning with portable, team-based simulation, hospitals can rehearse the procedure, identify workflow challenges, and build confidence before using the technique in a patient. To understand why implementation requires a new approach to training, it helps to first understand how ICG changes the conventional sentinel lymph node biopsy workflow. ## Challenging the standard of care with a different workflow Sentinel lymph node biopsies are used to identify the closest lymph nodes that drain a breast tumor. Examining these nodes helps clinicians assess whether cancer may have spread and informs subsequent treatment decisions. Conventional mapping commonly uses the radioactive tracer technetium-99m (99mTc), sometimes together with a blue dye. These methods are well established, but are practically limited. 99mTc is radioactive, requiring material handling and coordination with nuclear medicine. Depending on the protocol, patients may need preoperative appointments or injections. The tracer is manually tracked with gamma probe - which provides an audible signal for  tissue radioactivity. The lacking visual feedback can prolong procedure time and negatively influence physician confidence. Blue dye is easier to administer, but it can cause sustained visible staining and, in rare cases, an allergic reaction.![Breast\_SLN\_KS2](https://blog.quelimaging.com/hs-fs/hubfs/Breast_SLN_KS2.jpg?width=300&height=400&name=Breast_SLN_KS2.jpg) ICG offers a different approach. Once injected into the tumor bed, it collects in the lymphatic system and local lymph nodes. ICG can then be visualized in real-time using a near-infrared camera. Rather than relying primarily on the audible response of a gamma probe to detect a radioactive tracer, the surgical team can see the lymphatic drainage pathway and fluorescent lymph nodes to collect for biopsy. [Clinical studies have reported](https://pmc.ncbi.nlm.nih.gov/articles/PMC7541884/)sentinel-node identification rates with ICG are comparable to those achieved with 99mTc, while simplifying clinical logistics. But replacing 99mTc with ICG is not simply a matter of exchanging one agent for another. It introduces a different way of navigating the procedure. ## Why the learning curve matters ICG moves quickly through lymphatic vessels. This speed can be an advantage, allowing injection to fit more easily into the surgical workflow. It can also create new challenges. If the camera is used too early, the team may see diffuse fluorescence through superficial tissue without clearly identifying the correct surgical plane. If every fluorescent structure is followed, the signal may lead beyond the first draining node to additional nodes. More fluorescence does not always mean more clinically useful information. Depth also matters. [Near-infrared fluorescence is a surface-weighted imaging technique](https://shop.quelimaging.com/product/icg-equivalent-depth-sensitivity-target/). A node covered by fat may not become clearly visible until the surgeon has dissected close to the appropriate plane. Camera distance, viewing angle, display mode, room lighting, and blood in the field can all affect the appearance of the signal. Dr. Doeksen offered a practical message: > "...understand the anatomy, reach the correct plane, and then use fluorescence to support the dissection. The goal is not to'“chase the green,' but to combine the image with surgical judgment."![Breast\_SLN\_A](https://blog.quelimaging.com/hs-fs/hubfs/Breast_SLN_A.jpg?width=300&height=489&name=Breast_SLN_A.jpg) That lesson extends beyond the surgeon. Successful implementation requires coordination among the entire surgical team. Understanding tracer preparation, injection timing, sterile draping, camera setup, room lighting, image interpretation, specimen handling, and ex vivo confirmation are all critical to successful procedures. These are difficult skills to build by watching a demonstration or waiting for an appropriate patient case. ## Bringing realistic practice to the team [Mobula-IGM](https://mobula-igm.com) has developed a [team-based training program](https://mobula-igm.com/from-listening-to-doing-together-two-interactive-mornings-with-alrijne-hospital/) that can be delivered in hospitals, skills laboratories, conference venues, and other educational settings. The goal is to bring the procedure to the clinical team rather than requiring the team to learn only in the operating room. Participants can rehearse the complete workflow: preparing the imaging system, deciding when to use the camera, dissecting toward the appropriate tissue plane, locating the fluorescent node, and confirming the signal after excision. Just as importantly, participants can experience how their decisions affect the image. They can move the camera too far from the field, activate it too early, approach the target at the wrong depth, or misinterpret a diffuse signal. In a simulated environment, the team can pause, discuss what happened, and retry the procedure without risking patient safety. To support this training, QUEL Imaging has been working with Mobula-IGM to [develop a reusable, non-animal physical model](https://quelimaging.com/products/) for ICG-guided sentinel lymph node procedures. The model recreates relevant breast and axillary anatomy using materials designed to represent the near-infrared optical properties of tissue. Fluorescent structures simulate lymphatic pathways and sentinel nodes beneath skin- and fat-like layers. Participants must therefore combine anatomy, dissection, camera handling, and image interpretation rather than simply locating an obvious bright target. Because the model does not require animal tissue, radioactive material, a live patient, or access to an operating room, the same exercise can be brought to different teams and repeated under consistent conditions. Before the hands-on session, participants can complete a foundational [e-learning module through Mobula Academy](https://mobula-igm.com/academy/#courses), a service provided by Mobula-IGM. The module introduces the rationale for the procedure, the major workflow steps, equipment considerations, and common pitfalls. This gives participants a shared foundation so that in-person time can focus on practice, troubleshooting, and team communication. The two formats serve different purposes. E-learning explains the concepts. Hands-on simulation allows the team to experience how tissue depth, camera position, dissection, and coordination influence what they actually see. ## Training is part of adoption For hospitals considering ICG, simulation provides a practical way to evaluate the procedure before introducing it into patient care. Teams can clarify responsibilities, identify equipment needs, refine local protocols, and become familiar with the imaging system in a lower-pressure environment. This preparation is especially important when transitioning from an established 99mTc workflow. Some teams may begin by using ICG alongside their current method, comparing the findings and building trust before deciding whether to change routine practice. Training makes that transition deliberate rather than improvised. Mobula-IGM brings clinical education, team-based instruction, and implementation experience to this process. QUEL Imaging contributes reusable, optically characterized models that reproduce clinically relevant fluorescence-imaging challenges. Together, the aim is to make realistic practice available wherever teams are preparing to adopt the technique. The lesson from Leiden was not merely that ICG works. It was that successful adoption must be learned. By giving clinical teams a place to practice before the first patient case, training can help turn a promising, potentially greener alternative into a dependable clinical workflow. ## From Development to Adoption, We’re Here to Help Successful clinical translation requires different tools at each stage. Whether you are developing a new fluorescence technology, preparing for a clinical trial, standardizing workflows across study sites, or training teams to adopt an approved product, [QUEL Imaging can help you](https://quelimaging.com/services/) build the physical models, characterization methods, validation tools, and training resources needed to move forward with confidence. Tell us where your program is today, and [let’s discuss](https://quelimaging.com/services/#ServiceRequest) how we can help accelerate its path into clinical use. [clinical translation](https://blog.quelimaging.com/tag/clinical-translation) ## Related posts [![QUEL Q logo on image outside the 2026 Stanford Symposium on Optical Surgical Navigation](https://blog.quelimaging.com/hs-fs/hubfs/Stanford_Q.jpg?height=200&name=Stanford_Q.jpg)](https://blog.quelimaging.com/lumicell-insights-2026-01) [clinical translation](https://blog.quelimaging.com/tag/clinical-translation) ## [Bridging the Gap in Fluorescence-Guided Surgery: Insights from Lumicell](https://blog.quelimaging.com/lumicell-insights-2026-01) ![Picture of Ethan LaRochelle](https://app.hubspot.com/settings/avatar/925081a77283a399dbd145b49b251212) [Ethan LaRochelle](https://blog.quelimaging.com/author/ethan) Jun 3, 2026, 6:15:01 AM At the 2026 Stanford Symposium on Optical Surgical Navigation, Brian Schlossberg, VP of Innovation... 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[Read more](https://blog.quelimaging.com/fda-draft-guidance) [![QUEL Q logo on image of Stanford'sLi Ka Shing Center](https://blog.quelimaging.com/hs-fs/hubfs/Stanford_Q.jpg?height=200&name=Stanford_Q.jpg)](https://blog.quelimaging.com/barth-reimbursement-strategy-2026-01) [clinical translation](https://blog.quelimaging.com/tag/clinical-translation), [regulatory](https://blog.quelimaging.com/tag/regulatory) ## [Charting a Course: Reimbursement Strategy for Optical Imaging Agents](https://blog.quelimaging.com/barth-reimbursement-strategy-2026-01) ![Picture of Ethan LaRochelle](https://app.hubspot.com/settings/avatar/925081a77283a399dbd145b49b251212) [Ethan LaRochelle](https://blog.quelimaging.com/author/ethan) Apr 28, 2026, 2:30:01 PM At the 2026 Stanford Symposium on Optical Surgical Navigation, two consecutive presentations... 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Main St. Suite 142 White River Junction, VT, USA Copyright © 2026, QUEL Imaging ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Ethan LaRochelle", "url" : "https://blog.quelimaging.com/author/ethan" }, "dateModified" : "2026-10-06T15:01:37.730Z", "datePublished" : "2026-10-06T14:58:14.000Z", "headline" : "Training Teams for ICG-Guided Sentinel Node Mapping", "image" : [ "https://blog.quelimaging.com/hubfs/Breast_SLN_KS.jpg" ], "mainEntityOfPage" : { "@id" : "https://blog.quelimaging.com/training-teams-for-icg-guided-sentinel-node-mapping", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://blog.quelimaging.com/hubfs/QUEL_Q.png" }, "name" : "QUEL Imaging" } } ```