Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media in microminipig: imaging protocol and feasibility

Tanahashi, Yoshikatsu; Iwasaki, Ryota; Shoda, Shinichi; Kawada, Hiroshi; Ando, Tomohiro; Takasu, Masaki; Hyodo, Fuminori; Goshima, Satoshi; Mori, Takashi

doi:10.1007/s00330-020-07031-0

Cited by 7 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Each dog was injected with each of the four contrast agents, each with a different viscosity (iohexol 350 room temperature [iohexol 350], iohexol 350 warmed [iohexol 350W], iohexol 240 room temperature [iohexol 240] and iohexol 240 warmed [iohexol 240W]) in a randomized order and randomized to left or right pelvic limb. Iohexol 350 has a viscosity of 23.3 cP at 20°C and 10.6 cP at 37°C while iohexol 240 has a viscosity of 5.6 cP at 20°C and 3.3 cP at 37°C 9 . Randomization was performed with a commercially available randomization software 15 .…”

Section: Methodsmentioning

confidence: 99%

“…One potential reason for failure of CT lymphangiography may be related to the viscosity of the contrast agent injected. In human CT lymphangiography, differences in viscosity between contrast agents have been proposed as a reason for differences in success rates or time to successful identification of SLNs, although no scientific study of this has been performed 8,9 . Canine studies have also reported dilution of contrast agents to reduce viscosity for performing CT lymphangiography for thoracic duct imaging for chylothorax 10,11 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of contrast agent viscosity and massage on success of computed tomography lymphangiography with aqueous contrast for sentinel lymph node identification in healthy dogs

Grimes

Reed

Beale

et al. 2021

Vet Comparative Oncology

View full text Add to dashboard Cite

Sentinel lymph node (SLN) evaluation is important for accurate cancer staging. Computed tomography (CT) lymphangiography with aqueous contrast is a feasible technique for SLN identification in dogs. Although most studies report success rates around 90%, success rates as low as 60% have been reported. One reason for low success rates may be the difference in viscosity of the various agents used in comparison to normal lymph viscosity. The objective of this study was to evaluate contrast agents of differing viscosities for use in CT lymphangiography for SLN identification and to determine the influence of massage on contrast flow rates. The hypothesis was that lower viscosity agents would have a higher success rate and faster time to identification of the SLN than higher viscosity agents and that massage would increase contrast flow rates. Dogs were anaesthetised and CT lymphangiography was performed with four contrast agents of differing viscosities in a randomized crossover design. Injections were made on the dorsal pes bilaterally on two study days and the popliteal lymph nodes were evaluated for contrast uptake. There was no significant difference in success of SLN identification or time to SLN identification among the four agents. Massage of the injection site increased rate of contrast flow through the lymphatics. No specific recommendation for one contrast agent over another can be made with these results. Massage is recommended to improve lymphatic flow when performing CT lymphangiography with aqueous contrast in dogs.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of contrast agent viscosity and massage on success of computed tomography lymphangiography with aqueous contrast for sentinel lymph node identification in healthy dogs

Grimes

Reed

Beale

et al. 2021

Vet Comparative Oncology

View full text Add to dashboard Cite

show abstract

“…More recently, initial small case series and case reports have described CTL with transnodal injection of water-soluble x-ray contrast agent as a technically simpler alternative to DC-MRL 35,81–83 . Dynamic contrast-enhanced MRL poses several logistical challenges, including necessary nodal needle placement outside of the scanner room with a theoretic risk of needle dislodgement during transfer back into the MR scanner 84 .…”

Section: Transnodal X-ray Lymphangiographymentioning

confidence: 99%

“…80 More recently, initial small case series and case reports have described CTL with transnodal injection of water-soluble x-ray contrast agent as a technically simpler alternative to DC-MRL. 35,[81][82][83] Dynamic contrast-enhanced MRL poses several logistical challenges, including necessary nodal needle placement outside of the scanner room with a theoretic risk of needle dislodgement during transfer back into the MR scanner. 84 Logistics of nodal CTL are less complex, scanning is faster, CT scanners are more accessible, and contraindications such as presence of active implanted devices or severe claustrophobia do not apply with CT.…”

Section: Ct Lymphangiographymentioning

confidence: 99%

Back to the Future II—A Comprehensive Update on the Rapidly Evolving Field of Lymphatic Imaging and Interventions

Pieper

2023

Invest Radiol

View full text Add to dashboard Cite

Lymphatic imaging and interventional therapies of disorders affecting the lymphatic vascular system have evolved rapidly in recent years. Although x-ray lymphangiography had been all but replaced by the advent of cross-sectional imaging and the scientific focus shifted to lymph node imaging (eg, for detection of metastatic disease), interest in lymph vessel imaging was rekindled by the introduction of lymphatic interventional treatments in the late 1990s. Although x-ray lymphangiography is still the mainstay imaging technique to guide interventional procedures, several other, often less invasive, techniques have been developed more recently to evaluate the lymphatic vascular system and associated pathologies. Especially the introduction of magnetic resonance, and even more recently computed tomography, lymphangiography with water-soluble iodinated contrast agent has furthered our understanding of complex pathophysiological backgrounds of lymphatic diseases. This has led to an improvement of treatment approaches, especially of nontraumatic disorders caused by lymphatic flow abnormalities including plastic bronchitis, protein-losing enteropathy, and nontraumatic chylolymphatic leakages. The therapeutic armamentarium has also constantly grown and diversified in recent years with the introduction of more complex catheter-based and interstitial embolization techniques, lymph vessel stenting, lymphovenous anastomoses, as well as (targeted) medical treatment options. The aim of this article is to review the relevant spectrum of lymphatic disorders with currently available radiological imaging and interventional techniques, as well as the application of these methods in specific, individual clinical situations.

show abstract

“…Basic studies of CT lymphangiography in animals are scarce. CT lymphangiography in swine [ 9 ], rabbits [ 10 ], and dogs [ 11 ] has been reported, but the application of this technique in mice, which are commonly used in fundamental laboratory experiments and are less expensive, has not been reported. By contrast, various reports on magnetic resonance (MR) lymphangiography in mice have been available in the literature since the early 2000s.…”

Section: Introductionmentioning

confidence: 99%

Feasibility study of direct CT lymphangiography in mice: comparison with interstitial CT/MR lymphangiography

et al. 2023

View full text Add to dashboard Cite

Objectives To establish a CT lymphangiography method in mice via direct lymph node puncture. Methods We injected healthy mice (n = 8) with 50 µl of water-soluble iodine contrast agent (iomeprol; iodine concentration, 350 mg/mL) subcutaneously into the left-rear foot pad (interstitial injection) and 20 µl of the same contrast agent directly into the popliteal lymph node (direct puncture) 2 days later. Additionally, we performed interstitial MR lymphangiography on eight mice as a control group. We calculated the contrast ratio for each lymph node and visually assessed the depiction of lymph nodes and lymphatic vessels on a three-point scale. Results The contrast ratios of 2-min post-injection images of sacral and lumbar–aortic lymph nodes were 20.7 ± 16.6 (average ± standard deviation) and 17.1 ± 12.0 in the direct puncture group, which were significantly higher than those detected in the CT or MR interstitial lymphangiography groups (average, 1.8–3.6; p = 0.008–0.019). The visual assessment scores for sacral lymph nodes, lumbar–aortic lymph nodes, and cisterna chyli were significantly better in the direct puncture group than in the CT interstitial injection group (p = 0.036, 0.009 and 0.001, respectively). The lymphatic vessels between these structures were significantly better scored in direct puncture group than in the CT or MR interstitial lymphangiography groups at 2 min after injection (all p ≤ 0.05). Conclusions In CT lymphangiography in mice, the direct lymph node puncture provides a better delineation of the lymphatic pathways than the CT/MR interstitial injection method. Key Points •The contrast ratios of 2-min post-injection images in the direct CT lymphangiography group were significantly higher than those of CT/MR interstitial lymphangiography groups. •The visibility of lymphatic vessels in subjective analysis in the direct CT lymphangiography group was significantly better in the direct puncture group than in the CT/MR interstitial lymphangiography groups. •CT lymphangiography with direct lymph node puncture can provide excellent lymphatic delineation with contrast being maximum at 2 min after injection.

show abstract

Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media in microminipig: imaging protocol and feasibility

Cited by 7 publications

References 20 publications

Effect of contrast agent viscosity and massage on success of computed tomography lymphangiography with aqueous contrast for sentinel lymph node identification in healthy dogs

Effect of contrast agent viscosity and massage on success of computed tomography lymphangiography with aqueous contrast for sentinel lymph node identification in healthy dogs

Back to the Future II—A Comprehensive Update on the Rapidly Evolving Field of Lymphatic Imaging and Interventions

Feasibility study of direct CT lymphangiography in mice: comparison with interstitial CT/MR lymphangiography

Contact Info

Product

Resources

About