Ultrasonographic Algorithm for the Assessment of Sentinel Lymph Nodes That Drain the Mammary Carcinomas in Female Dogs

The status of sentinel lymph nodes (SLNs) is decisive in staging, prognosis, and therapeutic approach. Using an ultrasonographic examination algorithm composed of B-mode, Doppler technique, contrast-enhanced ultrasound (CEUS) and elastography, this study aimed to determine the diagnostic performance of the four techniques compared to histopathological examination. 96 SLNs belonging to 71 female dogs with mammary gland carcinomas were examined. After examinations, mastectomy and lymphadenectomy were performed. Histopathological examination confirmed the presence of metastases in 54 SLNs. The elasticity score had the highest accuracy—89.71%, identifying metastases in SLNs with 88.9.9% sensitivity (SE) and 90.5% specificity (SP), ROC analysis providing excellent results. The S/L (short axis/long axis) ratio showed 83.3% SE and 78.6% SP as a predictor of the presence of metastases in SLN having a good accuracy of 81.2%. On Doppler examination, the resistivity index(RI) showed good accuracy of 80% in characterizing lymph nodes with metastases versus unaffected ones; the same results being obtained by CEUS examination. By assigning to each ultrasonographic parameter a score (0 or 1) and summing up the scores of the four techniques, we obtained the best diagnostic performance in identifying lymph node metastases with 92.2% accuracy. In conclusion, the use of the presented algorithm provides the best identification of metastases in SLNs, helping in mammary carcinoma staging and appropriate therapeutic management.

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Contrast-enhanced ultrasound biopsy of sentinel lymph nodes in patients with breast cancer undergoing neo-adjuvant chemotherapy

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.02.217 ◽

2016 ◽

Vol 42 (5) ◽

pp. S57

Author(s):

Sarah Horn ◽

Jenny Weeks ◽

Pippa Mills ◽

David Fish ◽

Karina Cox

Keyword(s):

Breast Cancer ◽

Adjuvant Chemotherapy ◽

Lymph Nodes ◽

Sentinel Lymph Nodes ◽

Contrast Enhanced Ultrasound ◽

Contrast Enhanced ◽

Neo Adjuvant Chemotherapy

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Contrast-enhanced lymphatic ultrasound imaging (lymphosonography) of sentinel lymph nodes in a melanoma animal model

Ultrasound in Medicine & Biology ◽

10.1016/s0301-5629(03)00413-7 ◽

2003 ◽

Vol 29 (5) ◽

pp. S95-S96

Author(s):

B.B. Goldberg ◽

D.A. Merton ◽

J. Liu ◽

M. Thakur ◽

G.F. Murphy ◽

...

Keyword(s):

Animal Model ◽

Lymph Nodes ◽

Ultrasound Imaging ◽

Sentinel Lymph Nodes ◽

Contrast Enhanced

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0536: Gray-Scale Contrast-Enhanced Utrasound in Detecting the Sentinel Lymph Nodes: An Animal Study

Ultrasound in Medicine & Biology ◽

10.1016/j.ultrasmedbio.2009.06.301 ◽

2009 ◽

Vol 35 (8) ◽

pp. S77 ◽

Cited By ~ 1

Author(s):

Yuexiang Wang ◽

Jie Tang ◽

Junlai Li ◽

Zhigang Cheng

Keyword(s):

Lymph Nodes ◽

Animal Study ◽

Sentinel Lymph Nodes ◽

Gray Scale ◽

Contrast Enhanced

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Sentinel Lymph Nodes in a Swine Model with Melanoma: Contrast-enhanced Lymphatic US

Radiology ◽

10.1148/radiol.2303021440 ◽

2004 ◽

Vol 230 (3) ◽

pp. 727-734 ◽

Cited By ~ 109

Author(s):

Barry B. Goldberg ◽

Daniel A. Merton ◽

Ji-Bin Liu ◽

Mathew Thakur ◽

George F. Murphy ◽

...

Keyword(s):

Lymph Nodes ◽

Sentinel Lymph Nodes ◽

Swine Model ◽

Contrast Enhanced

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Gray-Scale Contrast-Enhanced Ultrasonography Of Sentinel Lymph Nodes In A Metastatic

Academic Radiology ◽

10.1016/j.acra.2009.03.007 ◽

2009 ◽

Vol 16 (8) ◽

pp. 957-962 ◽

Cited By ~ 8

Author(s):

Yuexiang Wang ◽

Wei Wang ◽

Junlai Li ◽

Jie Tang

Keyword(s):

Lymph Nodes ◽

Sentinel Lymph Nodes ◽

Gray Scale ◽

Contrast Enhanced ◽

Contrast Enhanced Ultrasonography

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Abstract P3-01-14: Nomogram predicting axillary lymph node metastases to skip intraoperative analysis of sentinel lymph nodes

10.1158/1538-7445.sabcs17-p3-01-14 ◽

2018 ◽

Author(s):

JH Park ◽

YW Ju ◽

KE Kim ◽

J Rhu ◽

Y Kim ◽

...

Keyword(s):

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Axillary Lymph Node ◽

Sentinel Lymph Nodes ◽

Axillary Lymph ◽

Axillary Lymph Node Metastases ◽

Node Metastases

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Standard ultrastaging compared to one-step nucleic acid amplification (OSNA) for the detection of sentinel lymph node metastases in early stage cervical cancer

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2020-001710 ◽

2020 ◽

Vol 30 (12) ◽

pp. 1871-1877

Author(s):

Angela Santoro ◽

Giuseppe Angelico ◽

Frediano Inzani ◽

Damiano Arciuolo ◽

Saveria Spadola ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Lymph Nodes ◽

Early Stage ◽

Sentinel Lymph Nodes ◽

Nucleic Acid Amplification ◽

Lymph Node Status ◽

Pelvic Lymph Nodes ◽

Lymph Node Assessment ◽

Node Metastases

ObjectiveWe compared ultrastaging and one-step nucleic acid amplification (OSNA) examination of sentinel lymph nodes in two homogeneous patient populations diagnosed with early stage cervical cancer. The primary aim of our study was to evaluate the rate and type of sentinel lymph node metastases detected by ultrastaging and OSNA assay. Secondary aims were to define the sensitivity and the negative predictive value of sentinel lymph node biopsy assessed with OSNA and ultrastaging and to define the role of sentinel lymph node assessment in predicting non-sentinel lymph node status.MethodsConsecutive patients who underwent surgery (radical hysterectomy or trachelectomy or cervical conization) at our institution, between January 2018 and March 2020, were enrolled. All patients had a preoperative diagnosis of early-stage cervical carcinoma (International Federation of Gynecology and Obstetrics (FIGO) 2018 stages IA–IIB) and underwent sentinel lymph node assessment with ultrastaging or OSNA. Patients with advanced FIGO stages and special histology subtypes (other than squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma) or patients with sentinel lymph nodes analyzed only with hematoxylin and eosin were excluded. Clinical data were compared using the χ2 test and Fisher’s exact test. A κ coefficient was determined with respect to lymph node assessment. A p value <0.05 was considered statistically significant.ResultsA total of 116 patients were included in this retrospective analysis (53 ultrastaging, 63 OSNA). Overall, 531 and 605 lymph nodes were removed in the ultrastaging and OSNA groups, respectively, and 140 and 129 sentinel lymph nodes were analyzed in the ultrastaging and OSNA groups, respectively. 22 patients had metastatic sentinel lymph nodes: 6 (11.3%) of 53 patients in the ultrastaging group and 16 (25.4%) of 63 patients in the OSNA group. The total amount of positive SLNs was 7 (5%) of 140 in the ultrastaging group and 21 (16.3%) of 129 in the OSNA group, respectively (p=0.0047). Pelvic lymphadenectomy was performed in 26 (49.1%) of 53 patients in the ultrastaging group and in 34 (54%) of 63 patients in the OSNA group due to comorbidities. Metastatic non-sentinel lymph nodes were found in 4 patients: 2 (7.7%) of 26 patients in the ultrastaging group and 2 (5.9%) of 34 patients in the OSNA group, respectively. The total amount of positive pelvic lymph nodes was 3 (0.6%) of 531 in the ultrastaging group and 4 (0.7%) of 605 in the OSNA group (p=0.61). In the OSNA group, only 2 patients with negative sentinel lymph nodes had metastatic disease in the pelvic lymph nodes. By contrast, no patients with OSNA-positive sentinel lymph nodes had metastases in the pelvic lymph nodes. In the ultrastaging group, all patients with negative sentinel lymph nodes did not have metastatic disease in other pelvic lymph nodes.ConclusionsOSNA assessment of sentinel lymph nodes was associated with a negative predictive value of 91% but poor reliability in detecting node metastases in non-sentinel pelvic lymph nodes. Of note, the ultrastaging protocol revealed higher sensitivity and more reliability in predicting pelvic non-sentinel lymph node status.

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