LIHNCS - Lugol’s iodine in head and neck cancer surgery: a multicentre, randomised controlled trial assessing the effectiveness of Lugol’s iodine to assist excision of moderate dysplasia, severe dysplasia and carcinoma in situ at mucosal resection margins of oral and oropharyngeal squamous cell carcinoma: study protocol for a randomised controlled trial

McCaul, James; Cymerman, James; Hislop, Stuart; McConkey, Christopher C.; McMahon, Jeremy; Mehanna, Hisham; Shaw, Richard; Sutton, David; Dunn, Janet A.

doi:10.1186/1745-6215-14-310

Cited by 20 publications

(11 citation statements)

References 9 publications

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“…Other use of Lugol staining described may lead to a reduction in local recurrence, and improved survival is to assist excision of dysplasias and carcinomas in situ at mucosal resection margins of oral and oropharyngeal squamous cell. [ 48 ] This early application of the dye at time of resection in our view may have results similar to ours without impact on the survival and cause larger resections with worse quality of life.…”

Section: Discussionsupporting

confidence: 68%

Lugol chromoscopy in the follow-up of head and neck carcinoma

Durazzo

et al. 2017

Ann Maxillofac Surg

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Introduction:Lugol is helpful in identifying early second primary tumors (SPTs) during oroscopy and pharyngoscopy, but this technique has not been assessed during follow-up visits with these patients.Aim:The aim of this study is to describe the use of Lugol (a low-cost method) to diagnose SPTs in the oral cavity and oropharynx.Methods:Patients treated for squamous cell carcinoma of the head and neck were randomly assigned to two groups. Group A was examined with routine oroscopy and pharyngoscopy without Lugol, and Group B was examined with routine oroscopy and pharyngoscopy without stain and with Lugol. A total of 211 patients were included during 4 years.Results:Six oral and oropharynx carcinomas were detected in Group A. Eighteen oral and oropharynx carcinomas were detected in Group B, twelve of which were not seen without chromoscopy but were detected with Lugol.Conclusion:Lugol increases the detection of malignant lesions compared to routine examination alone.

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Section: Discussionsupporting

confidence: 68%

Lugol chromoscopy in the follow-up of head and neck carcinoma

Durazzo

et al. 2017

Ann Maxillofac Surg

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“…When planning staining of a tissue sample, the total volume and the relative volume and the different affinity towards the stain influence the staining result. Lugol's solution has been reported to preferentially stain glycogen [33, 34], which has an exceptionally high binding capacity to iodine [35]. Moreover, iodine binds to lipids, such as found in myelinated nervous tissue [36].…”

Section: Discussionmentioning

confidence: 99%

Iodine-Enhanced Micro-CT Imaging of Soft Tissue on the Example of Peripheral Nerve Regeneration

Heimel

Swiadek

Slezak

et al. 2019

Contrast Media & Molecular Imaging

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Microcomputed tomography (μCT) is widely used for the study of mineralized tissues, but a similar use for soft tissues is hindered by their low X-ray attenuation. This limitation can be overcome by the recent development of different staining techniques. Staining with Lugol’s solution, a mixture of one part iodine and two parts potassium iodide in water, stands out among these techniques for its low complexity and cost. Currently, Lugol staining is mostly used for anatomical examination of tissues. In the present study, we seek to optimize the quality and reproducibility of the staining for ex vivo visualization of soft tissues in the context of a peripheral nerve regeneration model in the rat. We show that the staining result not only depends on the concentration of the staining solution but also on the amount of stain in relation to the tissue volume and composition, necessitating careful adaptation of the staining protocol to the respective specimen tissue. This optimization can be simplified by a stepwise staining which we show to yield a similar result compared to staining in a single step. Lugol staining solution results in concentration-dependent tissue shrinkage which can be minimized but not eliminated. We compared the shrinkage of tendon, nerve, skeletal muscle, heart, brain, and kidney with six iterations of Lugol staining. 60 ml of 0.3% Lugol’s solution per cm3 of tissue for 24 h yielded good results on the example of a peripheral nerve regeneration model, and we were able to show that the regenerating nerve inside a silk fibroin tube can be visualized in 3D using this staining technique. This information helps in deciding the region of interest for histological imaging and provides a 3D context to histological findings. Correlating both imaging modalities has the potential to improve the understanding of the regenerative process.

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“…When planning staining of a tissue sample, the total volume and the relative volume as well as the different affinity towards the stain influence the staining result. Lugol's solution has been reported to preferentially stain glycogen [33,34] which has an exceptionally high binding capacity to iodine [35]. Moreover, iodine binds to lipids, such as found in myelinated nervous tissue [36].…”

Section: Discussionmentioning

confidence: 99%

Iodine-enhanced micro-CT imaging of soft tissue on the example of peripheral nerve regeneration

Heimel¹,

Swiadek

Slezak

et al. 2018

Preprint

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Microcomputed tomography (µCT) is widely used for the study of mineralized tissues but a similar use for soft tissues is hindered by their low X-ray attenuation. This limitation can be overcome by the recent development of different staining techniques. Staining with Lugol's solution, a mixture of one part iodine and two parts potassium iodide in water, stands out among these techniques for its low complexity and cost. Currently, Lugol staining is mostly used for anatomical examination of tissues. In the present study we seek to optimize the quality and reproducibility of the staining for ex vivo visualization of soft tissues in the context of a peripheral nerve regeneration model in the rat.We show that the staining result not only depends on the concentration of the staining solution, but also on the amount of stain in relation to the tissue volume and composition, necessitating careful adaptation of the staining protocol to the respective specimen tissue. This optimization can be simplified by a stepwise staining which we show to yield a similar result compared to staining in a single step. Lugol staining solution results in concentration dependent tissue shrinkage which can be minimized but not eliminated. We compared the shrinkage of tendon, nerve, skeletal muscle, heart, brain and kidney with six iterations of Lugol staining. 60 ml of 0.3% Lugol's solution per cm³ of tissue for 24h yielded good results on the example of a peripheral nerve regeneration model and we were able to show that the regenerating nerve inside a silk fibroin tube can be visualized in 3D using this staining technique. This information helps in deciding the region of interest for histological imaging and provides a 3D context to histological findings. Correlating both imaging modalities has the potential to improve the understanding of the regenerative process.

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Cited by 20 publications

References 9 publications

Lugol chromoscopy in the follow-up of head and neck carcinoma

Lugol chromoscopy in the follow-up of head and neck carcinoma

Iodine-Enhanced Micro-CT Imaging of Soft Tissue on the Example of Peripheral Nerve Regeneration

Iodine-enhanced micro-CT imaging of soft tissue on the example of peripheral nerve regeneration

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