Percutaneous removal of sentinel lymph nodes in a swine model using a breast lesion excision system and contrast-enhanced ultrasound

Sever, Ali; Mills, P.; Hyvelin, Jean-Marc; Weeks, Jenny; Gümüş, Hatice; Fish, David E.; Mali, W. P. T. M.; Jones, Susan; Jones, Peter A.; Devalia, Haresh

doi:10.1007/s00330-011-2293-1

Cited by 12 publications

(6 citation statements)

References 27 publications

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“…Sentinel LNs enhancement patterns were associated with the metastatic status of the nodes, but a direct clinical application is nonetheless limited as a result of the low sensitivity and specificity. No adverse event was reported following lymphosonography in client‐owned dogs with MCTs, which confirms the safety of this technique 27,29,31,32,44 …”

Section: Discussionsupporting

confidence: 65%

Contrast‐enhanced ultrasound for sentinel lymph node mapping in the routine staging of canine mast cell tumours: A feasibility study

Fournier

Thierry

Longo

et al. 2020

Vet Comparative Oncology

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Canine mast cell tumours (MCTs) typically spread to lymph nodes (LNs) before reaching distant sites, and LN assessment is an important part of MCT staging. Sentinel LN (SLN) mapping techniques to identify draining LNs are being developed and could improve the accuracy of MCT staging. The primary objective of this feasibility study was to determine the safety and effectiveness of contrast-enhanced ultrasound (CEUS) to identify SLNs. Secondary objectives were to determine if the SLNs identified by CEUS coincided with the regional LN predicted by the anatomical lymphosomes, if previous MCT excision altered CEUS SLN findings, and if CEUS could identify MCT nodal metastases. Between June 2017 and March 2019, 59 dogs with 62 MCTs were enrolled. No adverse events related to CEUS were reported. CEUS detected at least 1 SLN in 59/62 MCTs (95.2%, 95% CI: 86.5-99.0%). In only 32/59 (54.2%) MCTs, clinicians would have correctly predicted the SLN(s) identified by CEUS. Among the 35 MCTs that had histological examination of the SLN(s), the prevalence of metastasis was 60% (95% CI: 42.1-76.1%). Additional staging procedures did not reveal any metastases in dogs with histologically non-metastatic SLNs. Integration of CEUS SLN mapping into the routine staging of MCTs is promising, but future studies are required to refine this procedure and to investigate if it would translate into a clinical benefit.

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Section: Discussionsupporting

confidence: 65%

Contrast‐enhanced ultrasound for sentinel lymph node mapping in the routine staging of canine mast cell tumours: A feasibility study

Fournier

Thierry

Longo

et al. 2020

Vet Comparative Oncology

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“…This result was repeated in a further 80-patient UK study [ 25 ]. In 2013, a larger study of 347 patients also found a low sensitivity of 61 % but a specificity of 100 % [ 26 ]. In the above three studies, there was no significant difference between the identification rates by CEUS and standard dual technique.…”

Section: Discussionmentioning

confidence: 99%

“…The constraints of the existing SLN biopsy techniques have led to the development of alternative methods. Indocyanine green fluorescence (ICG) [ 18 – 20 ], superparamagnetic iron oxide nanoparticles (SPIO) [ 21 , 22 ], and contrast-enhanced ultrasound (CEUS) using microbubbles have been reported as new feasible alternative techniques for the SLN biopsy in breast cancer [ 23 – 26 ]. Sulfur hexafluoride microbubbles is the most popular ultrasound contrast agent at present, which plays a role as an inert gas in vivo.…”

Section: Introductionmentioning

confidence: 99%

Intradermal microbubbles and contrast-enhanced ultrasound (CEUS) is a feasible approach for sentinel lymph node identification in early-stage breast cancer

et al. 2015

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BackgroundMicrobubbles and contrast-enhanced ultrasound (CEUS) is a new technique for locating sentinel lymph node (SLN). The aim of this study is to explore the feasibility of SLNs tracing by CEUS using microbubbles in breast cancer patients and the value of enhancing patterns in diagnosing lymph nodes metastases.MethodsA clinical trial was registered (trial registration: ChiCTR-DDT-13003778). One hundred and one consecutive consenting patients with breast cancer undergoing SLN biopsy were enrolled. Before the surgery, microbubble was injected periareolarly. Lymphatic drainage pathway was detected by CEUS, and guidewire was deployed to locate the SLN before the operation. Blue dye was also used to help in tracing sentinel lymph node during the operation. The identification rate and the accuracy rate were recorded. Enhancing patterns of lymph nodes were recorded and compared with the pathological diagnosis.ResultsOf the 101 cases, SLNs in 99 cases were successfully identified by at least one tracer, including 98 cases identified by CEUS and 97 cases by blue dye. There was no significant difference between the two methods (P = 0.705). Guidewires were deployed successfully in all 98 cases, and the localized SLNs were all isolated successfully in the following operations. The status of SLNs isolated by CEUS was completely identical to that of the whole axillary lymph node while 7.1 % cases were misdiagnosed as negative by blue dye method. The sensitivity of predicting SLNs metastases by CEUS enhancing pattern was 81.8 %, the specificity was 86.2 %, and the positive and negative predictive values were 75.0 and 90.3 %, respectively.ConclusionsMicrobubbles and CEUS are feasible approaches for SLN identification. The enhancing patterns on CEUS may be helpful to recognize the metastasizing SLNs. This novel method may be a promising technique for the clinical application.

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“…Sever et al . ( 31 ) injected SonoVue ® that was mixed with blue dye around the mammary papillae in two young pigs. The enhancing superficial inguinal lymph nodes were easily identified and successfully removed percutaneously by the breast lesion excision system (BLES).…”

Section: Review Of Literaturementioning

confidence: 99%

Contrast enhanced ultrasound of sentinel lymph nodes

et al. 2013

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Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient's prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and Definity®. This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.

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Percutaneous removal of sentinel lymph nodes in a swine model using a breast lesion excision system and contrast-enhanced ultrasound

Cited by 12 publications

References 27 publications

Contrast‐enhanced ultrasound for sentinel lymph node mapping in the routine staging of canine mast cell tumours: A feasibility study

Contrast‐enhanced ultrasound for sentinel lymph node mapping in the routine staging of canine mast cell tumours: A feasibility study

Intradermal microbubbles and contrast-enhanced ultrasound (CEUS) is a feasible approach for sentinel lymph node identification in early-stage breast cancer

Contrast enhanced ultrasound of sentinel lymph nodes

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