Determining agreement between preoperative computed tomography lymphography and indocyanine green near infrared fluorescence intraoperative imaging for sentinel lymph node mapping in dogs with oral tumours

Wan, Jennifer; Oblak, Michelle L.; Ram, Ann S.; Singh, Ameet; Nykamp, Stephanie

doi:10.1111/vco.12675

Cited by 31 publications

(55 citation statements)

References 46 publications

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“…While debate exists regarding the optimal technique for sentinel LN mapping, the use of dual methods (dye and advanced imaging) has been suggested to optimize sentinel LN detection. 12,29,30 However, in routine clinical practice, LN mapping is often restricted to methylene blue dye, mainly due to logistic issues related to radioisotopes, technical challenges and financial constraint.…”

Section: Discussionmentioning

confidence: 99%

Histologic grade has a higher‐weighted value than nodal status as predictor of outcome in dogs with cutaneous mast cell tumours and overtly metastatic sentinel lymph nodes

Guerra

Faroni

Sabattini

et al. 2022

Vet Comparative Oncology

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In canine cutaneous mast cell tumours (cMCTs), histologic grade and clinical stage are the most important prognostic factors, with high‐grade tumours and metastatic lymph nodes (LNs) significantly influencing the evolution of disease. However, it is uncertain whether histologic grade and clinical stage should be given equal weighting value in patient prognostication and management. Dogs with low‐ and high‐grade cMCTs and at least one overtly metastatic sentinel LN undergoing standardized treatment, consisting of surgical excision of the cMCT, lymphadenectomy and chemotherapy, were retrospectively included. The aim was to determine whether, at the same clinical stage, histologic grade retained prognostic relevance. Sixty dogs were included: 26 had a high‐grade cMCT tumour and 34 had a low‐grade cMCT. Median follow‐up was 367 days (range, 187–748) in the high‐grade group, and 1208 days (range, 180–2576) in the low‐grade group. Median time to progression was significantly shorter in the high‐grade group than in the low‐grade group (214 days versus not reached; p < .001), as well as tumour‐specific survival (545 days versus not reached; p < .001). On multivariable analysis, a high histologic grade and incomplete margins retained prognostic significance for both tumour progression and tumour‐specific death. In dogs with cMCT and at least one overtly metastatic LN undergoing multimodal treatment, histologic grade significantly correlated with outcome. Overall prognosis was not unfavourable, even in the high‐grade group, further supporting that a multimodal therapeutic approach, addressing primary tumour and sentinel LN, should be offered. Whether chemotherapy should be incorporated in the therapeutic planning of low‐grade cMCTs remains to be defined.

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Section: Discussionmentioning

confidence: 99%

Histologic grade has a higher‐weighted value than nodal status as predictor of outcome in dogs with cutaneous mast cell tumours and overtly metastatic sentinel lymph nodes

Guerra

Faroni

Sabattini

et al. 2022

Vet Comparative Oncology

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“…Using special camera devices with a light spectrum between 650 and 850 nm, the near-infrared fluorescent dye is lightening up the lymphatics to a tissue depth of 1 cm and displays the SLN on a screen in real time. Near-infrared fluorescent SLN mapping in dogs with oral malignancies was recently published by Wan et al (2021). However, there is currently no controlled clinical study available that documents the actual value of near-infrared fluorescent image-based LNDs in dogs affected by MCTs.…”

Section: Introductionmentioning

confidence: 99%

Near‐infrared fluorescent image‐guided lymph node dissection compared with locoregional lymphadenectomies in dogs with mast cell tumours

Beer

Rohrer-Bley

Nolff

2022

J of Small Animal Practice

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Objectives Near‐infrared fluorescent imaging has been described for intraoperative mapping of the draining lymph nodes in human cancer and canine oral tumours. The aim of this study was to retrospectively describe the results of lymphadenectomies in dogs with mast cell tumours treated either by standard unguided locoregional lymph node dissection or near‐infrared fluorescent image‐guided lymph node dissection. Methods Medical records between 2012 and 2020 were reviewed for dogs that were presented for surgical resection of mast cell tumours with concurrent lymphadenectomy either with (near‐infrared fluorescent image‐guided lymph node dissection) or without near‐infrared fluorescence image guidance (lymph node dissection). The number and location of lymph nodes planned for surgical dissection and actually dissected nodes, presence of metastases and perioperative complications were recorded. Results Thirty‐five patients underwent near‐infrared fluorescent image‐guided lymph node dissection, and 43 lymph node dissections. The number of nodes preoperatively planned for resection were 70 and 68, respectively. Fifty‐eight of those (83%) were identified during near‐infrared fluorescent image‐guided lymph node dissection procedures, compared with 50 (74%) during lymph node dissection. near‐infrared fluorescent image‐guided lymph node dissection resulted in resection of additional fluorescent nodes not corresponding to locoregional nodes in 15 of 35 dogs. Using near‐infrared fluorescent image‐guided lymph node dissection, we identified at least one metastatic node in 68% of dogs (24 of 35) compared with 33% (14 of 43) when lymph node dissection was used without imaging. No complications related to near‐infrared fluorescent imaging were reported. Clinical Significance The present study suggests that near‐infrared imaging is a promising technique for intraoperative detection of the draining lymph nodes in dogs with mast cell tumours. Further validation of the technique is required to assess if near‐infrared fluorescent imaging can detect the true sentinel lymph node.

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“…However, a study performed in dogs with oral neoplasia recently underlined the superior performance of ICG to methylene blue and CT lymphography. 25 Applications in cats have so far not been published. This case has shown that NIR-L is easy to perform in a cat and two clear lymphograms could be generated.…”

Section: Discussionmentioning

confidence: 99%

Indocyanine-based near-infrared lymphography for real-time detection of lymphatics in a cat with multiple mast cell tumours

Arz

Seehusen

Meier

et al. 2022

Journal of Feline Medicine and Surgery Open Reports

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Case summary An 11-year-old female domestic shorthair cat was presented with cutaneous mast cell tumours (MCTs) localised at the right temporal region, the left buccal region and on the third digit of the right thoracic limb. Staging was negative and locoregional lymph nodes appeared normal, based on clinical findings. During surgery, real-time indocyanine green (ICG)-based lymphography was performed to detect the cutaneous draining pattern of all the primary MCTs. ICG was injected intracutaneously in four quadrants around each tumour, and a clear lymphogram was visible shortly after injection. Using near-infrared lymphography (NIR-L) for guidance, all lymphadenectomies were performed in 12 mins or less, with a maximal incision length of 3.5 cm. The smallest resected node was 0.9 cm in diameter. All MCTs were classified as low-grade cutaneous MCT. All four ICG-positive lymph nodes were considered premetastatic or metastatic. The only ICG-negative resected node was also negative for tumour cells. No complications related to NIR-L were recorded. Relevance and novel information This is the first description of NIR-L in a cat with MCT. Application was straightforward and ICG enrichment only occurred in the metastatic nodes, suggesting correct identification of lymphatic draining patterns. Of note, as previously described in dogs, we did detect nodal metastasis, despite low-grade primary tumours. The clinical relevance should be evaluated in future studies.

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Determining agreement between preoperative computed tomography lymphography and indocyanine green near infrared fluorescence intraoperative imaging for sentinel lymph node mapping in dogs with oral tumours

Cited by 31 publications

References 46 publications

Histologic grade has a higher‐weighted value than nodal status as predictor of outcome in dogs with cutaneous mast cell tumours and overtly metastatic sentinel lymph nodes

Histologic grade has a higher‐weighted value than nodal status as predictor of outcome in dogs with cutaneous mast cell tumours and overtly metastatic sentinel lymph nodes

Near‐infrared fluorescent image‐guided lymph node dissection compared with locoregional lymphadenectomies in dogs with mast cell tumours

Indocyanine-based near-infrared lymphography for real-time detection of lymphatics in a cat with multiple mast cell tumours

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