scholarly journals Recent Developments of ICG-Guided Sentinel Lymph Node Mapping in Oral Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 891
Author(s):  
Ji-Hoon Kim ◽  
Minhee Ku ◽  
Jaemoon Yang ◽  
Hyung Kwon Byeon
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Oral Cancer ◽  
Neck Dissection ◽  
Sentinel Lymph Node Mapping ◽  
Surgical Oncology ◽  
Elective Neck Dissection ◽  
Accurate Identification ◽  
Lymph Node Mapping ◽  
Recent Developments

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.

scholarly journals CT lymphography for sentinel lymph node mapping of clinically N0 early oral cancer

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Satomi Sugiyama ◽  
Toshinori Iwai ◽  
Toshiharu Izumi ◽  
Keita Ishiguro ◽  
Junichi Baba ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Oral Cancer ◽  
Lymph Nodes ◽  
Contrast Medium ◽  
Sentinel Lymph Node Mapping ◽  
Ct Scanning ◽  
Optimal Timing ◽  
Ct Scanner ◽  
Lymph Node Mapping

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.

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 ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Oral Cancer ◽  
Sentinel Lymph Node Mapping ◽  
Lymph Node Mapping ◽  
Diagnostic Pitfall ◽  
Ct Lymphography

MR lymphography with superparamagnetic iron oxide for sentinel lymph node mapping of N0 early oral cancer: A pilot study

2020 ◽  
pp. 20200333
Author(s):  
Satomi Sugiyama ◽  
Toshinori Iwai ◽  
Junichi Baba ◽  
Senri Oguri ◽  
Toshiharu Izumi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Iron Oxide ◽  
Pilot Study ◽  
Sentinel Lymph Node ◽  
Oral Cancer ◽  
Superparamagnetic Iron Oxide ◽  
Sentinel Lymph Node Mapping ◽  
Lymph Node Mapping ◽  
Scanning Imaging ◽  
Ct Lymphography

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.

scholarly journals Elective Neck Dissection or Sentinel Lymph Node Biopsy in Early Stage Oral Cavity Cancer Patients: The Dutch Experience

Cancers ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1783 ◽  
Author(s):  
Inne J. den Toom ◽  
Koos Boeve ◽  
Daphne Lobeek ◽  
Elisabeth Bloemena ◽  
Maarten L. Donswijk ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Oral Cancer ◽  
Neck Dissection ◽  
Early Stage ◽  
Lymph Node Biopsy ◽  
Elective Neck Dissection ◽  
Floor Of Mouth ◽  
Node Biopsy

Background: Sentinel lymph node biopsy (SLNB) has been introduced as a diagnostic staging modality for detection of occult metastases in patients with early stage oral cancer. Comparisons regarding accuracy to the routinely used elective neck dissection (END) are lacking in literature. Methods: A retrospective, multicenter cohort study included 390 patients staged by END and 488 by SLNB. Results: The overall sensitivity (84% vs. 81%, p = 0.612) and negative predictive value (NPV) (93%, p = 1.000) were comparable between END and SLNB patients. The END cohort contained more pT2 tumours (51%) compared to the SLNB cohort (23%) (p < 0.001). No differences were found for sensitivity and NPV between SLNB and END divided by pT stage. In floor-of-mouth (FOM) tumours, SLNB had a lower sensitivity (63% vs. 92%, p = 0.006) and NPV (90% vs. 97%, p = 0.057) compared to END. Higher disease-specific survival (DSS) rates were found for pT1 SLNB patients compared to pT1 END patients (96% vs. 90%, p = 0.048). Conclusion: In the absence of randomized clinical trials, this study provides the highest available evidence that, in oral cancer, SLNB is as accurate as END in detecting occult lymph node metastases, except for floor-of-mouth tumours.

A Novel Sentinel Lymph Node Approach in Oral Squamous Cell Carcinoma

2020 ◽  
Vol 26 (31) ◽  
pp. 3834-3839 ◽  
Author(s):  
Åsa Kågedal ◽  
Gregori Margolin ◽  
Cornelia Held ◽  
Pedro F. N. da Silva ◽  
Krzysztof Piersiala ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Oral Cancer ◽  
Oral Squamous Cell Carcinoma ◽  
Sentinel Node ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Dissection ◽  
Elective Neck Dissection

Background: Occult metastases are common in patients with oral squamous cell carcinoma (OSCC) which is why elective neck dissection, adjuvant radiotherapy or watchful waiting have been treatment options after surgical removal of the primary tumour. Sentinel lymph node biopsy (SLNB) has lately emerged as a novel possibility in treatment planning. Objectives: To establish a reliable and clinically useful protocol for SLNB in staging/elective neck dissection in oral cancer. Methods: Fourteen consecutive patients with T1-T2 N0 oral cancer were enrolled when scheduled for elective neck dissection. Results: This study outlines various techniques for improving SLNB in head and neck cancer. After evaluation, a combination of techniques was found to constitute a reliable, clinically adaptable work concept. The suggested procedure starts with the pre-surgical injection of radioactive technetium 99Tcm carried on tilmanocept (Lymphoseek ®) at the tumour site. The radioactivity in the lymph node is then visualized preoperatively with Single Photon Emission Computed Tomography (SPECT/CT). Intraoperatively, indocyanine green (ICG) is injected and a sentinel node is visualized with near-infrared light. To support the sentinel node detection, the surgeon uses a hand-held gamma detection probe. This approach results in a reproducible and reliable detection of sentinel nodes. Conclusion: This paper presents a novel protocol for the identification of the sentinel node in the head and neck region. The protocol additionally enables the use of flow cytometry analysis of resected lymph nodes.

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