{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:54:54Z","timestamp":1781711694983,"version":"3.54.5"},"reference-count":30,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Systematic lymphadenectomy is recommended in apparent early-stage epithelial ovarian cancer (EOC) to assess nodal status, but it is associated with significant morbidity and lacks survival benefit. Sentinel lymph node (SLN) mapping may offer a less invasive alternative, although evidence remains limited due to the complexity of ovarian lymphatic drainage and methodological heterogeneity across studies. This prospective study evaluates the feasibility and diagnostic accuracy of a true hybrid 99mTc\u2013indocyanine green (ICG) tracer for SLN mapping in apparent early-stage EOC. Methods: A prospective observational study was conducted at a tertiary oncology center between 2021 and 2026. Patients presenting with a suspicious ovarian mass (Group A) or requiring restaging after adnexectomy for confirmed EOC (Group B) underwent SLN mapping using a hybrid 99mTc\u2013ICG tracer injected into the infundibulopelvic (IPL) and\/or utero-ovarian ligament (UOL). SLNs were identified using gamma detection and near-infrared fluorescence imaging. All malignant cases underwent complete surgical staging including systematic pelvic and para-aortic lymphadenectomy. SLNs were ultrastaged and compared with the final nodal status. Results: Forty patients were included; 20 (50%) had malignant tumors. The overall SLN detection rate was 92.5% (37\/40), with 100% in malignant cases. Among malignant tumors, 3\/20 (15%) had metastatic SLNs, all accurately detected (false-negative rate 0%). Sensitivity and negative predictive value were 100%. Combined pelvic and para-aortic drainage was the most frequent pattern (75%). Conclusions: SLN mapping may represent a feasible and potentially accurate staging strategy in apparent early-stage EOC. In the present study, a hybrid 99mTc\u2013ICG tracer was associated with high detection rates and complete concordance with final nodal status. These findings support further multicenter validation to define its potential role as an alternative to systematic lymphadenectomy.<\/jats:p>","DOI":"10.3390\/cancers18121973","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T15:11:22Z","timestamp":1781709082000},"page":"1973","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid 99mTc\u2013ICG Sentinel Lymph Node Mapping in Apparent Early-Stage Epithelial Ovarian Cancer: A First Prospective Evaluation of a True Molecular Hybrid Tracer (HibrOv Trial)"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2596-6819","authenticated-orcid":false,"given":"Joana","family":"Amengual Vila","sequence":"first","affiliation":[{"name":"Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Hospital Universitari Son Espases, 07120 Palma, Spain"},{"name":"School of Medicine, Universitat de les Illes Balears (UIB), 07120 Palma, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 Sanit\u00e0ria de les Illes Balears, IdISBa, 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina Maria","family":"Sampol Bas","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Hospital Universitari Son Espases, 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Quintero Duarte","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Universitari Son Espases, 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ane","family":"Ugarteburu P\u00e9rez","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Hospital Universitari Son Espases, 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Ruiz Coll","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Hospital Universitari Son Espases, 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Rioja Merlo","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Hospital Universitari Son Espases, 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2171-434X","authenticated-orcid":false,"given":"Anna","family":"Torrent Colomer","sequence":"additional","affiliation":[{"name":"Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Hospital Universitari Son Espases, 07120 Palma, Spain"},{"name":"School of Medicine, Universitat de les Illes Balears (UIB), 07120 Palma, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 Sanit\u00e0ria de les Illes Balears, IdISBa, 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1097\/IGC.0000000000001041","article-title":"European Society of Gynaecological Oncology (ESGO) Guidelines for Ovarian Cancer Surgery","volume":"27","author":"Querleu","year":"2017","journal-title":"Int. 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