Sentinel lymph node biopsy using computed tomographic lymphography in patients with early tongue cancer

Abstract

Conclusions: Because computed tomography (CT) lymphography provides preoperative images of anatomic relationships between a tumor, its associated lymph vessels, and the sentinel lymph node (SLN), it may aid in directing the SLN biopsy for management of early tongue cancer. Objectives: SLN biopsy using a radioisotope (RI) generally has been performed in head and neck cancer. However, this method can be performed only at institutions that are licenced for its use. In this study, we evaluated the utility of performing SLN biopsy in patients with early tongue cancer using the newly developed technique of CT lymphography. Methods: Enrolled in this study were 31 patients with T1N0 or T2N0 tongue cancer. CT images were obtained before and after injection of iopamidol into the peritumoral region and the SLN was identified as the first enhanced lymph node. SLN biopsy was performed using CT lymphographic guidance combined with blue dye injection. Results: The SLN was detected by CT lymphography in 28 cases (90.3%). By intraoperative frozen section examination, metastases to SLNs were found in 4 (14.3%) (T1N0, 1 patient; T2N0, 3 patients) of the 28 patients. Of these four, SLN micrometastases were found in one patient.

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

“…16 CT lymphography with iodine-based contrasts has the advantage of clear detection of SLN lying in the proximity of the primary tumour site with continuous anatomic visualization and was utilized for oral cancer SLN explorations. 17,18 Honda et al 19 conducted a study on 31 patients with cN0 with oral tongue SCC; the authors reported a high negative-predictive value of 95.8% and sensitivity value of 90.3%. MRI lymphography utilizing ultrasmall paramagnetic iron oxide or gadolinium chelates is capable of providing anatomically distinct and functional information.…”

“…Honda et al 19 imposed on a lattice marker which was attached to the neck skin during the CT scan. The SLN location was indicated by the crossing points of the lattice marker and the CT plane light.…”

A Review of Techniques for Sentinel Lymph Node Mapping with Special Reference to the Head and Neck Region

“…The SLN location was indicated precisely by the crossing points of the lattice marker and the CT plane light. 52 Overall CT lymphography has the advantage of clear detection of lymph nodes lying in the proximity of the primary tumor, with continuous anatomic visualization.…”

“…Honda et at. 52 conducted a study on 31 cNo patients with oral tongue SCC to assess the properties of CT-lymphography for SLN spotting. The authors reported high negative predictive value of 95, 8%, and sensitivity value of 90.3%.…”

Short-Term Dynamic Observation of the Color Change and Enhancement Effect of Polyethylenimine-Entrapped Gold Nanoparticles Used for Indirect Lymphography

“…Indirect CT lymphography (CT-LG) with iodine contrast agent and MRI lymphography (MRI-LG) with gadolinium-containing contrast agents have the advantages of high sensitivity, excellent spatial resolution and low doses of contrast agent needed [7], and have been widely used in SLNB [8,9,10]. However, there have been few clinical applications to identify SLNs in head and neck tumors [11,12] because of the very short duration of enhanced imaging with iodine or gadolinium-containing contrast agents. Therefore, a contrast agent with a longer enhancement duration is needed.…”