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

Honda K, Ishiyama K, Suzuki S, Oumi E, Sato T, Kawasaki Y, Saito H, Ishikawa K - Acta Otolaryngol. (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.

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.

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Related in: MedlinePlus

The sentinel lymph node (SLN) location was indicated precisely by the crossing points of the lattice marker and the CT plane light. Arrow, CT plane light.
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Figure 0002: The sentinel lymph node (SLN) location was indicated precisely by the crossing points of the lattice marker and the CT plane light. Arrow, CT plane light.

Mentions: CT lymphography was performed to identify the SLN on the day before the SLN biopsy and glossectomy. Each patient was placed in the same position as for the subsequent surgery, with the neck extended and inclined toward the healthy side. A lattice marker (CT Guidelines, FLAIR Co. Ltd, Tokyo, Japan), which is a commodity developed for the CT-guided needle biopsy, was attached to the skin at the neck. First, non-contrast CT images of the oral cavity and neck were obtained by using a 64 multi-detector row CT scanner (Discovery 750 HD, GE Healthcare, Milwaukee, WI, USA). CT scanning was performed with the following parameters: a tube voltage of 120 kVp, auto mA (noise index, 26.26), 0.969:1 beam pitch, standard reconstruction mode, 20 mm detector coverage, helical thickness of 0.625 mm, scan type of helical mode, and rotation time of 0.6 s. Next, 1.5 ml of iopamidol (Iopamidol 370; Bayer Healthcare, Osaka, Japan) and 0.5 ml of 1% lidocaine hydrochloride were mixed and injected into the peritumoral area with a 25-gauge needle. CT images were obtained 1, 3, 5, and 10 min after administration of the iopamidol. The CT images were analyzed at once and the SLN was identified as the first enhancing lymph node in the lymphatic flow from the injection site (Figure 1). The SLN location was indicated precisely by the crossing points of the lattice marker and the CT plane lights. This point was marked with an oil pen as the SLN (Figure 2).


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

Honda K, Ishiyama K, Suzuki S, Oumi E, Sato T, Kawasaki Y, Saito H, Ishikawa K - Acta Otolaryngol. (2015)

The sentinel lymph node (SLN) location was indicated precisely by the crossing points of the lattice marker and the CT plane light. Arrow, CT plane light.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4487571&req=5

Figure 0002: The sentinel lymph node (SLN) location was indicated precisely by the crossing points of the lattice marker and the CT plane light. Arrow, CT plane light.
Mentions: CT lymphography was performed to identify the SLN on the day before the SLN biopsy and glossectomy. Each patient was placed in the same position as for the subsequent surgery, with the neck extended and inclined toward the healthy side. A lattice marker (CT Guidelines, FLAIR Co. Ltd, Tokyo, Japan), which is a commodity developed for the CT-guided needle biopsy, was attached to the skin at the neck. First, non-contrast CT images of the oral cavity and neck were obtained by using a 64 multi-detector row CT scanner (Discovery 750 HD, GE Healthcare, Milwaukee, WI, USA). CT scanning was performed with the following parameters: a tube voltage of 120 kVp, auto mA (noise index, 26.26), 0.969:1 beam pitch, standard reconstruction mode, 20 mm detector coverage, helical thickness of 0.625 mm, scan type of helical mode, and rotation time of 0.6 s. Next, 1.5 ml of iopamidol (Iopamidol 370; Bayer Healthcare, Osaka, Japan) and 0.5 ml of 1% lidocaine hydrochloride were mixed and injected into the peritumoral area with a 25-gauge needle. CT images were obtained 1, 3, 5, and 10 min after administration of the iopamidol. The CT images were analyzed at once and the SLN was identified as the first enhancing lymph node in the lymphatic flow from the injection site (Figure 1). The SLN location was indicated precisely by the crossing points of the lattice marker and the CT plane lights. This point was marked with an oil pen as the SLN (Figure 2).

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology-Head and Neck Surgery.

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.

Show MeSH
Related in: MedlinePlus