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

Abstract

Computed tomographic lymphography using nanoscale iodized oil emulsion is a promising tool for preoperative SLN detection for early gastric cancer if the biological safety of the nanoscale iodized oil emulsion can be established.

Fluorescent Iodized Emulsion for Pre- and Intraoperative Sentinel Lymph Node Imaging: Validation in a Preclinical Model

“…However, CT lymphography itself cannot replace intraoperative SLN detection procedures; therefore, conventional dye methods that are based on intraoperative endoscopy are still required (14,15,18,30). Moreover, some discrepancies between SLN detection by using iodized oil-based CT lymphography and the dual tracer method were noticed (30).…”

“…In our previous study, we performed CT lymphography with a water-soluble nonparticulate iodinated contrast agent (iopamidol) but experienced rapid tracer washout and consequently low SLN detection rate (15). To overcome this issue, we used iodized oil emulsion as a CT lymphography tracer, which provided sufficient and sustained contrast enhancement of the draining LNs or reticuloendothelial organs in rat and canine models (18,20,29). Similarly, researchers in recent studies described iodized oil-based CT lymphography as The intervening lymphatic vessels (arrowheads) and LNs containing emulsion (arrows) were clearly visualized and traceable by using real-time NIR optical imaging.…”

“…Recently, several groups, including ours, have reported promising results for preoperative computed tomographic (CT) imaging of SLNs using iopamidol (Isovue; Bracco Diagnostics, Princeton, NJ) (15)(16)(17), iodized oil emulsion (18), and ethiodized oil (14) in patients with gastric cancer or animal models. Preoperative CT lymphography for SLN mapping has the advantages of providing anatomic information about SLNs without intraoperative procedures and of reducing the surgical operation time.…”

“…Preoperative CT lymphography for SLN mapping has the advantages of providing anatomic information about SLNs without intraoperative procedures and of reducing the surgical operation time. However, during the surgical operation, additional procedures for identifying SLNs are still necessary (14,15,17,18).…”

“…For endoscopic injection, the emulsion was endoscopically injected into the gastric submucosa by an experienced gastroenterologist (S.K.L., with 12 years of experience), as previously described (18). In brief, a flexible endoscope (GIF-Q260; Olympus, Tokyo, Japan) was inserted to inject emulsion into the gastric submucosa (three 0.3-mL injections, with 0.9 mL in total) within a narrow area surrounding a specific target.…”