Sentinel lymph node mapping of clinically N0 early oral cancer: a diagnostic pitfall on CT lymphography

2020 ◽  
Author(s):  
Satomi Sugiyama ◽  
Toshinori Iwai ◽  
Toshiharu Izumi ◽  
Junichi Baba ◽  
Senri Oguri ◽  
...  
2020 ◽  
pp. 20200333
Author(s):  
Satomi Sugiyama ◽  
Toshinori Iwai ◽  
Junichi Baba ◽  
Senri Oguri ◽  
Toshiharu Izumi ◽  
...  

Objectives: The purpose of this pilot study was to evaluate the usefulness of magnetic resonance lymphography (MRL) with superparamagnetic iron oxide (SPIO) in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer, and to conduct a comparative study of this MRL with CT lymphography (CTL). Methods: CTL and MRL were performed for SLN mapping before surgery for 20 patients with clinically N0 early oral cancer. The detection rate, number, and location of SLNs in CTL and MRL were evaluated. Furthermore, optimal scanning/imaging timing in MRL was examined. Results: SLNs were detected by CTL in 18 (90%) patients, and the total and mean number of SLN were 35 and 1.8, respectively. All SLNs could be detected 2 min and 3.5–5 min after contrast medium injection. In all patients, SLNs were detected by MRL at 10 min after SPIO injection, and the total and mean number of SLN was 53 and 2.7, respectively. MRL at 30 min after the injection showed additional 18 secondary lymph nodes. Conclusion: MRL with SPIO is safe and useful imaging for the detection of SLNs in clinically N0 early oral cancer, and the optimal imaging timing is 10 min after SPIO injection.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Satomi Sugiyama ◽  
Toshinori Iwai ◽  
Toshiharu Izumi ◽  
Keita Ishiguro ◽  
Junichi Baba ◽  
...  

Abstract Background The objectives of this retrospective study were to evaluate the usefulness of computed tomography lymphography (CTL) and to clarify the optimal timing of CTL in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer. Methods Twenty patients with clinically N0 early oral cancer underwent CTL with a 128 multi-detector row CT scanner to detect SLN the day before resection of primary tumor and SLN biopsy with indocyanine green (ICG) fluorescence guidance. CT scanning was performed in the first 10 patients at 2, 5, and 10 min after submucosal injection of iopamidol and in the remaining 10 patients at 2, 3.5, 5, and 10 min after the injection of contrast medium. We evaluated the SLN detection rate at each scan timing and the number and location of SLNs. We evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes. Results SLNs were detected by CTL in 19 of the 20 patients (95.0%), and the mean number of SLNs was 2 (range, 1–4). All SLNs were located on the ipsilateral side; 35 of 37 SLNs were located at level I and II, and 2 SLNs were lingual lymph nodes. All SLNs could be detected 2 min and 3.5–5 min after contrast medium injection, and CTL-enhanced SLNs could be identified intraoperatively as fluorescent lymph nodes. Conclusions CTL could facilitate the detection of SLNs in early oral cancer, and the optimal timing of CT scanning was at 2 and 5 min after injection of contrast medium.


Radiology ◽  
2004 ◽  
Vol 230 (2) ◽  
pp. 543-552 ◽  
Author(s):  
Kazuyoshi Suga ◽  
Yue Yuan ◽  
Munemasa Okada ◽  
Naofumi Matsunaga ◽  
Akira Tangoku ◽  
...  

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 891
Author(s):  
Ji-Hoon Kim ◽  
Minhee Ku ◽  
Jaemoon Yang ◽  
Hyung Kwon Byeon

Sentinel lymph node (SLN) biopsy has gained attention as a method of minimizing the extent of neck dissection with a similar survival rate as elective neck dissection in oral cancer. Indocyanine green (ICG) imaging is widely used in the field of surgical oncology. Real-time ICG-guided SLN imaging has been widely used in minimally invasive surgeries for various types of cancers. Here, we provide an overview of conventional SLN biopsy and ICG-guided SLN mapping techniques for oral cancer. Although ICG has many strengths, it still has limitations regarding its potential use as an ideal compound for SLN mapping. The development of novel fluorophores and imaging technology is needed for accurate identification of SLNs, which will allow precision surgery that would reduce morbidities and increase patient survival.


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