Contrast-Enhanced Sonographic Imaging of Lymphatic Channels and Sentinel Lymph Nodes

Goldberg, Barry B.; Merton, Daniel A.; Liu, Ji‐Bin; Murphy, Gëorge F.; Forsberg, Flemming

doi:10.7863/jum.2005.24.7.953

Cited by 109 publications

(117 citation statements)

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“…35 We previously assessed several different US contrast agents for evaluations of the lymphatic system in a number of areas of the body (including subcutaneous, submucosal, and parenchymal injections) in a variety of animal models. 17 In addition to confirming that lymphosonography could be performed for a variety of lymphatic applications, the benefits of using a reticuloendothelialspecific agent such as Sonazoid for lymphatic applications became apparent during these investigations. Furthermore, scanning electron microscopy confirmed that the microbubbles of this agent remain intact after being phagocytized by normal LN macrophages.…”

Section: Discussionmentioning

confidence: 99%

“…17 Additional preliminary investigations were performed using a swine model with naturally occurring melanoma tumors, which confirmed that lymphosonography can be used to identify LCs and SLNs after peritumoral injections of the US contrast agent Sonazoid (GE Healthcare, Oslo, Norway). 18 However, the number of swine evaluated in those initial experiments was very small (only 6 swine).…”

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confidence: 93%

“…52 Our published results using CEUS to evaluate the lymphatic system in a number of animal species after subcutaneous, submucosal, and parenchymal injections suggest that lymphosonography has the potential to detect SLNs from a variety of malignancies, including colon, prostate, breast, as well as head and neck cancers. 17,18,53,54 However, clinical investigations are needed to determine if the results of these animal studies can be replicated in humans. Once the contrast-enhanced SLNs have been localized via lymphosonography, conventional US criteria such as LN size or alterations in morphologic characteristics could be used to characterize the LNs.…”

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confidence: 99%

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Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Goldberg

Merton

Liu

et al. 2011

Journal of Ultrasound in Medicine

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etection and characterization of sentinel lymph nodes (SLNs) are important for the management of patients who have a variety of malignancies, including melanoma, breast, colon, and other cancers. [1][2][3][4] Various techniques and imaging agents have been developed to map lymphatic drainage from tumors, including the use of blue dye with surgical dissection and injection of radiopharmaceuticals followed by evaluation with a gamma camBarry B. Goldberg, MD, Daniel A. Merton, BS, RDMS, Ji-Bin Liu, MD, Flemming Forsberg, PhD, Kaijun Zhang, PhD, Madhukar Thakur, PhD, Stephanie Schulz, PhD, Robin Schanche, BS, George F. Murphy, MD, Scott A. Waldman, MD, PhD Received October 6, 2010, ORIGINAL RESEARCHObjectives-The purpose of this study was to compare lymphosonography (ie, contrast-enhanced ultrasound imaging [US] after interstitial injection of a US contrast agent) for the detection of sentinel lymph nodes (SLNs) in swine with naturally occurring melanoma tumors to lymphoscintigraphy using blue dye-guided surgical dissection as the reference standard. Also, we sought to determine if lymphosonography can be used to characterize SLNs.Methods-Sixty-three swine with 104 melanomas were evaluated. Contrast-specific US was performed after peritumoral injection (1 mL dose) of Sonazoid (GE Healthcare, Oslo, Norway). Lymphoscintigraphy was performed after peritumoral injections of technetium Tc 99m sulfur colloid. Peritumoral injection of 1% Lymphazurin (Ben Venue Labs, Inc, Bedford, OH) was used to guide SLN resection. The accuracy of SLN detection with the two imaging modalities was compared using the McNemar test. The SLNs were qualitatively and quantitatively characterized as benign or malignant based on the lymphosonography results with histopathology and RNA analyses used as the reference standards.Results-Blue dye-guided surgery identified 351 SLNs. Lymphosonography detected 293 SLNs and 11 false-positives, while lymphoscintigraphy detected 231 SLNs and 20 false-positives. The accuracy of SLN detection was 81.8% for lymphosonography, which was significantly higher than the 63.2% achieved with lymphoscintigraphy (P < .0001). The accuracy of lymphosonography for SLN characterization was 80%. When the size of the enhanced SLN was taken into consideration to characterize SLNs, the accuracy was 86%.Conclusions-Lymphosonography is statistically better than lymphoscintigraphy for the detection of SLNs in this animal model. The ability to use lymphosonography as a means to characterize SLNs as benign or malignant is limited.

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Section: Discussionmentioning

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confidence: 93%

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confidence: 99%

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Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Goldberg

Merton

Liu

et al. 2011

Journal of Ultrasound in Medicine

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“…Experimental studies demonstrated the prospects of microbubble contrast ultrasound in SLN detection. [28][29][30] Sulfur hexafluoride microbubble is the most widely used ultrasound contrast agent, as it acts as an inert gas in vivo with no evidence of its metabolism. The diameters of the microbubbles range from 2 mm to 10 mm (mean 2.5 mm), which is smaller than that of an erythrocyte (mean 7.2 mm).…”

Section: Resultsmentioning

confidence: 99%

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

Gvetadze

Xiong

et al. 2017

Dentomaxillofacial Radiology

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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.

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“…63 Experimental studies demonstrated potential benefits of usage of US related contrasts in SLN detection. 64,65 Contrast enhanced ultrasound (CEUS) agents are composed of a dispersion of microbubbles (each is smaller than a red blood cell) that act as reflectors of the ultrasound beam. In high mechanical index settings the microbubbles are rapidly destroyed by high acoustic pressure known as acoustic emission effect.…”

Section: 54mentioning

confidence: 99%

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

Sun¹

2016

ICPJL

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Sentinel lymph node biopsy is an extensively explored diagnostic mean for reducing surgical risks while improving staging in different human malignancies. Several different techniques have been introduced to clinical use during last two decades. Methods as ink lymphography and lymphoscintigraphy have already established their position in sentinel nodes mapping. Novel approaches as CT, MRI-lymphography, contrast enhanced ultrasound and near-infrared fluorescence imaging possesses prominent potential advantages and demand further experience gaining. A review of the clinically utilized techniques is presented a special attention is drawn to their usefulness in the head and neck carcinomas work-up. Keywords

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Contrast-Enhanced Sonographic Imaging of Lymphatic Channels and Sentinel Lymph Nodes

Abstract: Lymphosonography can be used to detect lymphatic drainage pathways and SLNs in a variety of animal models.

Cited by 109 publications

References 28 publications

Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

Contrast-Enhanced Ultrasound Imaging of Sentinel Lymph Nodes After Peritumoral Administration of Sonazoid in a Melanoma Tumor Animal Model

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

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

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