Lymphatic Drainage from Esophagogastric Tract: Feasibility of Endoscopic CT Lymphography for Direct Visualization of Pathways

Suga, Kazuyoshi; Shimizu, Kensaku; Kawakami, Yoshiyuki; Tangoku, Akira; Zaki, Mohammed; Matsunaga, Naofumi; Oka, M.

doi:10.1148/radiol.2373041578

Cited by 37 publications

(35 citation statements)

References 32 publications

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“…CT lymphography, however, allows clear detection of lymph nodes adjacent to the primary tumour and has the advantage of visualization of nodes in an anatomically continuous manner. [6][7][8][9] Although metallic artefacts sometimes interfere with the view of the level II nodes, CT lymphography is suitable for visualization of small in-transit nodes like the lingual lymph nodes located near the primary tumour.…”

Section: Discussionmentioning

confidence: 99%

The lingual lymph node identified as a sentinel node on CT lymphography in a patient with cN0 squamous cell carcinoma of the tongue

Saito

Nishiyama²,

Oda³

et al. 2012

Dentomaxillofacial Radiology

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We performed CT lymphography on an 81-year-old female patient with a histologically confirmed squamous cell carcinoma of the tongue with no clinical or radiological evidence of cervical lymph node involvement. The lateral lingual lymph node was identified as a sentinel node, which is the first lymph node to receive drainage from a primary tumour. CT lymphography also showed draining lymphatics passing through the sublingual space, the medial side of the submandibular gland and near the hyoid bone and connected with the middle internal jugular node. Although metastasis to the lateral lingual lymph node is known as one of the crucial events in determining survival outcome in cancer of the tongue and floor of the mouth, very few reports are available on the imaging of the lateral lingual lymph node metastasis. This is the first report regarding the lateral lingual lymph node identified as a sentinel node demonstrated on CT lymphography.

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Section: Discussionmentioning

confidence: 99%

The lingual lymph node identified as a sentinel node on CT lymphography in a patient with cN0 squamous cell carcinoma of the tongue

Saito

Nishiyama²,

Oda³

et al. 2012

Dentomaxillofacial Radiology

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show abstract

“…In most of these attempts, commercially available, water-soluble non-particulate iodine contrast agent was used as a tracer [14][15][16][17]. However, CT lymphography using water-soluble non-particulate iodine contrast agent in gastric cancer patients has shown considerable differences in the detection rates of SLNs (28.6-83.3%) [15,17].…”

Section: Discussionmentioning

confidence: 99%

“…The mean attenuation value in Hounsfield units (HU) was then calculated (Table 1). LN enhancement was judged to be positive if its attenuation on post-contrast images was 30 HU greater than its attenuation on pre-contrast images [16]; those LNs were considered SLNs. The time course of SLN enhancement was plotted, and the maximum diameter of each enhanced LN was measured.…”

Section: Imaging Analysismentioning

confidence: 99%

“…Preoperative SLN mapping via interstitial computed tomographic (CT) lymphography using radio-contrast agents is gaining interest because it may increase the detection rate of SLNs intraoperatively and it gives accurate anatomical information on SLNs [14][15][16][17]. Pretreatment identification of the SLNs in gastric cancer patients using CT lymphography may have great advantages for minimally invasive surgery.…”

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confidence: 99%

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Nanoscale iodized oil emulsion: a useful tracer for pretreatment sentinel node detection using CT lymphography in a normal canine gastric model

et al. 2012

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“…48,49) CT lymphography (CTLG) with endoscopic mucosal injection of iopamidol was applicable for SLN navigation of superficial esophageal cancer. [50][51][52] The multiple-angle views of 3D, CT image sets provided a comprehensive anatomy of these lymphatic pathways (Fig. 6A and 6B).…”

Section: Another Strategy For Measuring Tumor Extent Of Superficial Ementioning

confidence: 99%

The New Era of Staging as a Key for an Appropriate Treatment for Esophageal Cancer

Tangoku

Yamamoto

Furukita

et al. 2012

Ann Thorac Cardiovasc Surg

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Fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) have become the gold standard for staging of esophageal cancer by detecting distant metastases, but metastatic lymph nodes are often difficult to diagnose from the size and standardized uptake value (SUV). If we compare the diagnostic performance of endoscopic ultrasonography (EUS), CT, and FDG-PET in staging of esophageal cancer, EUS is the most sensitive method to identify the detection of regional lymph node metastases, whereas CT and FDG-PET are more specific tests. Combination study with CT, EUS and PETCT cannot make a precise diagnosis after neoadjuvant therapy (NAT). A precise staging might be determined by the fine needle aspiration biopsy (FNAB) under EUS and US screening in the neck and the abdomen even after NAT. Indication of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for superficial cancer is sensitive because of difficulty in T1b cancer diagnosis. Detailed examination about vessel invasion and the possibility of residual tumor with dissected specimen will offer an appropriate additional therapy. New strategy like sentinel lymph node (SLN) navigation could supply more information about lymphatic routes and metastatic nodes. SLN navigation with ESD might become a new less invasive strategy for superficial esophageal cancer.

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Lymphatic Drainage from Esophagogastric Tract: Feasibility of Endoscopic CT Lymphography for Direct Visualization of Pathways

Abstract: Endoscopic CT lymphography is a feasible method for visualizing the direct connection between and the accurate anatomic location of SLNs and lymphatic drainage vessels.

Cited by 37 publications

References 32 publications

The lingual lymph node identified as a sentinel node on CT lymphography in a patient with cN0 squamous cell carcinoma of the tongue

The lingual lymph node identified as a sentinel node on CT lymphography in a patient with cN0 squamous cell carcinoma of the tongue

Nanoscale iodized oil emulsion: a useful tracer for pretreatment sentinel node detection using CT lymphography in a normal canine gastric model

The New Era of Staging as a Key for an Appropriate Treatment for Esophageal Cancer

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