Dynamic MR lymphangiography and carbon dye for sentinel lymph node detection: A solution for sentinel lymph node biopsy in mucosal head and neck cancer

Nason, Richard W.; Torchia, Mark G.; Morales, Carlos Andrés Collazos; Thliveris, James A.

doi:10.1002/hed.20173

Cited by 30 publications

(19 citation statements)

References 24 publications

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“…The histological morphology of carbon deposits within the marked LNs was identical to our findings in the ex vivo SLN mapping in gastric cancer [1] and to the illustrations given in the literature. The feasibility of carbon dye as an adjunct to standard marker dyes has been proven in animal models and in a small number of human studies [2,3,5,10]. The accordance of our results with data in the literature indicates that the thesis of SLN mapping by colonic tattooing is correct.…”

Section: Discussionsupporting

confidence: 94%

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Sentinel lymph node mapping as a side-effect of colonoscopic tattooing

et al. 2009

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Section: Discussionsupporting

confidence: 94%

“…Carbon-containing lymph nodes (CcLNs) could be detected in 17 of 21 cases. This detection rate of 81% is in the range of reported data from conventional sentinel mapping in colorectal cancer [7][8][9][10]. Also comparable to data in the literature is the mean number of marked LNs, with 2 ± 2 per case.…”

Section: Discussionsupporting

confidence: 84%

Sentinel lymph node mapping as a side-effect of colonoscopic tattooing

et al. 2009

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“…Indirect MR lymphangiography has been used to localize SLN in a porcine model. 7 While this method can be accurate, CT is applied more frequently than MR in developing countries.…”

Section: Discussionmentioning

confidence: 99%

Preliminary study of indirect CT lymphography-guided sentinel lymph node biopsy in a tongue VX2 carcinoma model

Hui

et al. 2009

International Journal of Oral and Maxillofacial Surgery

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“…More studies should investigate the technical aspects of harvesting the SLN. Novel methods for SLN detection are currently under investigation, as are the use of MR lymphangiography and carbon dye labeling [44]. Furthermore, it still remains uncertain how best to handle the SLN.…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy is unsuitable for routine practice in younger female patients with unilateral low-risk papillary thyroid carcinoma

Huang

Wang

et al. 2011

BMC Cancer

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BackgroundSentinel lymph node (SLN) biopsy has been used to assess patients with papillary thyroid carcinoma (PTC). To achieve its full potential the rate of SLN identification must be as close to 100 percent as possible. In the present study we compared the combination of preoperative lymphoscintigraphy scanning by sulfur colloid labeled with 99 m Technetium, gamma-probe guided surgery, and methylene blue with methylene blue, alone, for sentinel node identification in younger women with unilateral low-risk PTC.MethodsFrom January 2004 to January 2007, 90 female patients, ages 23 to 44 (mean = 35), with unilateral low-risk PTC (T1-2N0M0) were prospectively studied. Mean tumor size was 1.3 cm (range, 0.8-3.7 cm). All patients underwent unilateral modified neck dissection. Prior to surgery, patients had, by random assignment, identification and biopsy of SLNs by methylene blue, alone (Group 1), or by sulfur colloid labeled with 99 m Technetium, gamma-probe guided surgery and methylene blue (Group 2).ResultsIn the methylene blue group, SLNs were identified in 39 of 45 patients (86.7%). Of the 39 patients, 28 (71.8%) had positive cervical lymph nodes (pN+), and 21 patients (53.8%) had pSLN+. In 7 of the 28 pN+ patients (25%), metastases were also detected in non-SLN, thus giving a false-negative rate (FNR of 38.9% (7/18), a negative predictive value (NPV) of 61.1% (11/18), and an accuracy of 82.1% (32/39). In the combined technique group, the identification rate (IR) of SLN was 100% (45/45). Of the 45 patients, 27 (60.0%) had pN+, 24 (53.3%) had pSLN+. There was a FNR of 14.3% (3/21), a NPV of 85.7% (18/21), and an accuracy of 93.3% (42/45). The combined techniques group was significantly superior to the methylene blue group in IR (p = 0.035). There were no significant differences between two groups in sensitivity, specificity, NPV, or accuracy. Location of pN+ (55 patients) in 84 patients was: level I and V, no patients; level II, 1 patient (1.2%); level III, 6 patients (7.2%); level III and IV, 8 patients (9.5%); level IV, alone, 8 patients (9.5%); level VI, 32 patients (38.1%). In all 90 patients, IR of SLN was 93.3%, FNR, 25.6%, NPV, 74.4%, and accuracy rate, 88.1 percent.ConclusionsCompared to a single technique, there was a significantly higher SLN identification rate for the combined technique in younger female with ipsilateral, low-risk PTC (T1-2N0M0). Thus, a combined SLN biopsy technique seems to more accurately stage lymph nodes, with better identification of SLN located out of the central compartment. Regardless of the procedure used, the high FNR renders the current SLN techniques unsuitable for routine practice. Based on these results, prophylactic node dissection of level VI might be considered because 38.1% of our patients had such node metastases.

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Dynamic MR lymphangiography and carbon dye for sentinel lymph node detection: A solution for sentinel lymph node biopsy in mucosal head and neck cancer

Abstract: MR lymphangiography provides temporal and anatomic localization of the sentinel lymph node with a single investigation. Carbon dye is a sensitive and persistent visual marker of MRI-targeted sentinel lymph nodes.

Cited by 30 publications

References 24 publications

Sentinel lymph node mapping as a side-effect of colonoscopic tattooing

Sentinel lymph node mapping as a side-effect of colonoscopic tattooing

Preliminary study of indirect CT lymphography-guided sentinel lymph node biopsy in a tongue VX2 carcinoma model

Sentinel lymph node biopsy is unsuitable for routine practice in younger female patients with unilateral low-risk papillary thyroid carcinoma

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