Detection of sentinel lymph node using contrast-enhanced agent, Sonazoid^™, and evaluation of its metastasis with superb microvascular imaging in oral and oropharyngeal cancers: a preliminary clinical study

New Developments in Imaging for Sentinel Lymph Node Biopsy in Early-Stage Oral Cavity Squamous Cell Carcinoma

“…To review contrast-enhanced lymphosonography in OSCC, a systematic literature search was conducted, which led to retrieval of 107 PubMed indexed articles. A total of 6 studies were considered relevant (i.e., 2 clinical studies [ 34 , 35 ] and 4 large animal studies [ 82 , 83 , 84 , 85 ]). Cross-reference did not lead to identification of additional relevant articles.…”

“…Figure 7 illustrates the procedure used in the two clinical studies [ 34 , 35 ]. Gvetadze et al [ 34 ] used sulfur hexafluoride (SF 6 ) phospholipid microbubbles (SonoVue; Bracco International B.V.) in 12 patients with T1-2cN0 oral tongue carcinoma and looked for lymph node enhancement after repetitive peritumoral injections.…”

“…No attempt was made at intraoperative localization of identified SLNs and therefore the correlation between identified SLNs and histopathological assessment was lacking. In the second clinical study, Wakisaka et al [ 35 ] studied lymphosonography with perfluorobutane phospholipid (C x F y ) microbubbles (Sonazoid; GE Healthcare, UK) in 10 patients with T1-4N0 oral or oropharyngeal carcinomas. Sonazoid was injected in four peritumoral locations.…”

“…No follow-up results were reported for both studies. Contrast-related adverse events did not occur [ 34 , 35 ].…”

“…Secondly, lymphosonography is not affected by the shine-through phenomenon. Furthermore, none of the studies in humans or large animals found HEN enhancement [ 34 , 35 , 82 , 83 , 84 , 85 ]. It is possible that this is prevented by phagocytosis of microbubbles (which was histologically confirmed in animals for Sonazoid [ 85 ]) and the size of microbubbles compared to small-molecule dyes.…”