Contrast-enhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer—a pilot study

Abstract

Objectives: To assess the usefulness of contrast-enhanced ultrasound (CEUS) with peritumoral injection of microbubble contrast agent for detecting the sentinel lymph nodes for oral tongue carcinoma. Methods: The study was carried out on 12 patients with T1-2cN0 oral tongue cancer. A radical resection of the primary disease was planned; a modified radical supraomohyoid neck dissection was reserved for patients with larger lesions (T2, n 5 8). The treatment plan and execution were not influenced by sentinel node mapping outcome. The SonovueÔ contrast agent (Bracco Imaging, Milan, Italy) was utilized. After detection, the position and radiologic features of the sentinel nodes were recorded. Results: The identification rate of the sentinel nodes was 91.7%; one patient failed to demonstrate any enhanced areas. A total of 15 sentinel nodes were found in the rest of the 11 cases, with a mean of 1.4 nodes for each patient. The sentinel nodes were localized in: Level IA-1 (6.7%) node; Level IB-11 (73.3%) nodes; Level IIA-3 (20.0%) nodes. No contrastrelated adverse effects were observed. Conclusions: For oral tongue tumours, CEUS is a feasible and potentially widely available approach of sentinel node mapping. Further clinical research is required to establish the position of CEUS detection of the sentinel nodes in oral cavity cancers. Dentomaxillofacial Radiology (2017Radiology ( ) 46, 20160345. doi: 10.1259 Cite this article as: Gvetadze SR, Xiong P, Lv M, Li J, Hu J, Ilkaev KD, et al. Contrastenhanced ultrasound mapping of sentinel lymph nodes in oral tongue cancer-a pilot study.

New Developments in Imaging for Sentinel Lymph Node Biopsy in Early-Stage Oral Cavity Squamous Cell Carcinoma

“…To review contrast-enhanced lymphosonography in OSCC, a systematic literature search was conducted, which led to retrieval of 107 PubMed indexed articles. A total of 6 studies were considered relevant (i.e., 2 clinical studies [ 34 , 35 ] and 4 large animal studies [ 82 , 83 , 84 , 85 ]). Cross-reference did not lead to identification of additional relevant articles.…”

“…Figure 7 illustrates the procedure used in the two clinical studies [ 34 , 35 ]. Gvetadze et al [ 34 ] used sulfur hexafluoride (SF 6 ) phospholipid microbubbles (SonoVue; Bracco International B.V.) in 12 patients with T1-2cN0 oral tongue carcinoma and looked for lymph node enhancement after repetitive peritumoral injections. Fifteen SLNs were identified in 11/12 patients (91.7%).…”

“…No follow-up results were reported for both studies. Contrast-related adverse events did not occur [ 34 , 35 ].…”

“…Secondly, lymphosonography is not affected by the shine-through phenomenon. Furthermore, none of the studies in humans or large animals found HEN enhancement [ 34 , 35 , 82 , 83 , 84 , 85 ]. It is possible that this is prevented by phagocytosis of microbubbles (which was histologically confirmed in animals for Sonazoid [ 85 ]) and the size of microbubbles compared to small-molecule dyes.…”

Imaging diagnostic methods for identification of sentinel lymph nodes in patients with early squamous cell carcinoma of the oral cavity mucosa: a literature review

“…В работе S. Gvetadze и соавт. [51] впервые описан предварительный опыт клинического применения контрастно-усиленного УЗИ в отслеживании (картировании) СЛУ у 12 пациентов с ранним ПКР языка с частотой выявления СЛУ, равной 91,7%. СЛУ располагались в следующих уровнях шеи: уровень IA -6,7%; уровень IB -73,3%; уровень IIА -20%.…”