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Li P, Sun D. Advanced diagnostic imaging of sentinel lymph node in early stage breast cancer. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:415-421. [PMID: 35092313 PMCID: PMC9303781 DOI: 10.1002/jcu.23151] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
Sentinel lymph node biopsy has been regarded as the standard procedure for early staging breast cancer. One of the key steps is to locate the sentinel lymph node (SLN). The recommended method is the joint use of blue dye and radioisotope. However, due to radionuclide radiation and high cost, it is urgent to develop more convenient and sensitive imaging methods to accurately locate SLN. This article discusses the advancement of accurately locating SLN by isotope tracer imaging, magnetic tracer method, computed tomographic lymphography, and trans-lymphatic contrast-enhanced ultrasound, as well as proposing new propose for clinical diagnosis.
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Affiliation(s)
- Ping Li
- Weifang Medical UniversityWeifangShandongChina
- Department of UltrasonographyPeking University Shenzhen HospitalShenzhenGuangdongChina
| | - Desheng Sun
- Department of UltrasonographyPeking University Shenzhen HospitalShenzhenGuangdongChina
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Mahieu R, de Maar JS, Nieuwenhuis ER, Deckers R, Moonen C, Alic L, ten Haken B, de Keizer B, de Bree R. New Developments in Imaging for Sentinel Lymph Node Biopsy in Early-Stage Oral Cavity Squamous Cell Carcinoma. Cancers (Basel) 2020; 12:cancers12103055. [PMID: 33092093 PMCID: PMC7589685 DOI: 10.3390/cancers12103055] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/03/2020] [Accepted: 10/15/2020] [Indexed: 12/18/2022] Open
Abstract
Sentinel lymph node biopsy (SLNB) is a diagnostic staging procedure that aims to identify the first draining lymph node(s) from the primary tumor, the sentinel lymph nodes (SLN), as their histopathological status reflects the histopathological status of the rest of the nodal basin. The routine SLNB procedure consists of peritumoral injections with a technetium-99m [99mTc]-labelled radiotracer followed by lymphoscintigraphy and SPECT-CT imaging. Based on these imaging results, the identified SLNs are marked for surgical extirpation and are subjected to histopathological assessment. The routine SLNB procedure has proven to reliably stage the clinically negative neck in early-stage oral squamous cell carcinoma (OSCC). However, an infamous limitation arises in situations where SLNs are located in close vicinity of the tracer injection site. In these cases, the hotspot of the injection site can hide adjacent SLNs and hamper the discrimination between tracer injection site and SLNs (shine-through phenomenon). Therefore, technical developments are needed to bring the diagnostic accuracy of SLNB for early-stage OSCC to a higher level. This review evaluates novel SLNB imaging techniques for early-stage OSCC: MR lymphography, CT lymphography, PET lymphoscintigraphy and contrast-enhanced lymphosonography. Furthermore, their reported diagnostic accuracy is described and their relative merits, disadvantages and potential applications are outlined.
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Affiliation(s)
- Rutger Mahieu
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, University of Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Josanne S. de Maar
- Division of Imaging and Oncology, University Medical Center Utrecht, University of Utrecht, 3584 CX Utrecht, The Netherlands; (J.S.d.M.); (R.D.); (C.M.)
| | - Eliane R. Nieuwenhuis
- Department of Magnetic Detection & Imaging, University of Twente, 7522 NB Enschede, The Netherlands; (E.R.N.); (L.A.); (B.t.H.)
| | - Roel Deckers
- Division of Imaging and Oncology, University Medical Center Utrecht, University of Utrecht, 3584 CX Utrecht, The Netherlands; (J.S.d.M.); (R.D.); (C.M.)
| | - Chrit Moonen
- Division of Imaging and Oncology, University Medical Center Utrecht, University of Utrecht, 3584 CX Utrecht, The Netherlands; (J.S.d.M.); (R.D.); (C.M.)
| | - Lejla Alic
- Department of Magnetic Detection & Imaging, University of Twente, 7522 NB Enschede, The Netherlands; (E.R.N.); (L.A.); (B.t.H.)
| | - Bennie ten Haken
- Department of Magnetic Detection & Imaging, University of Twente, 7522 NB Enschede, The Netherlands; (E.R.N.); (L.A.); (B.t.H.)
| | - Bart de Keizer
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, University of Utrecht, 3584 CX Utrecht, The Netherlands;
- Correspondence: ; Tel.: +31-88-7550819
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Gvetadze SR, Ilkaev KD. Lingual lymph nodes: Anatomy, clinical considerations, and oncological significance. World J Clin Oncol 2020; 11:337-347. [PMID: 32874949 PMCID: PMC7450815 DOI: 10.5306/wjco.v11.i6.337] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/04/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023] Open
Abstract
Lingual lymph nodes are an inconstant group of in-transit nodes, which are located on the route of lymph drainage from the tongue mucosa to the regional nodes in neck levels I and II. There is growing academic data on the metastatic spread of oral cancer, particularly regarding the spreading of oral tongue squamous cell carcinoma to lingual nodes. These nodes are not currently included in diagnostic and treatment protocols for oral tongue cancer. Combined information on surgical anatomy, clinical observations, means of detection, and prognostic value is presented. Anatomically obtained incidence of lingual nodes ranges from 8.6% to 30.2%. Incidence of lingual lymph node metastasis ranges from 1.3% to 17.1%. It is clear that lymph nodes that bear intervening tissues from the floor of the mouth should be removed to improve loco-regional control. Extended resection volume, which is required for the surgical treatment of lingual node metastasis, cannot be implied to every tongue cancer patient. As these lesions significantly influence prognosis, special efforts of their detection must be made. Reasonably, every tongue cancer patient must be investigated for the existence of lingual lymph node metastasis. Lymphographic tracing methods, which are currently implied for sentinel lymph node biopsies, may improve the detection of lingual lymph nodes.
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Affiliation(s)
- Shalva R Gvetadze
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow 119991, Russia
| | - Konstantin D Ilkaev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow 119991, Russia
- Blokhin National Medical Research Center of Oncology, Moscow 115478, Russia
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Cai W, Chen M, Fan J, Jin H, Yu D, Qiang S, Peng C, Yu J. Fluorescein sodium loaded by polyethyleneimine for fundus fluorescein angiography improves adhesion. Nanomedicine (Lond) 2019; 14:2595-2611. [PMID: 31361188 DOI: 10.2217/nnm-2019-0008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Aim: To improve the retention of fluorescein sodium (FS) as a kind of clinical contrast agent for fundus fluorescein angiography (FFA). Materials & methods: Polyethyleneimine (PEI) was designed to synthesize PEI–NHAc–FS nanoparticles (NPs), and the formed NPs were characterized by both physicochemical properties and their effects on FFA. Results: Compared with free FS, PEI–NHAc–FS NPs showed similar optical performance, and could obviously reduce cellular adsorption and uptake both in vitro and in vivo, which could promote the metabolism of NPs in ocular blood vessels. Conclusion: PEI–NHAc–FS NPs represent a smart nanosize fluorescence contrast agent, which hold promising potential for clinical FFA diagnosis, therapy and research work.
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Affiliation(s)
- Wenting Cai
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, PR China
| | - Meixiu Chen
- State Key Laboratory for Modification of Chemical Fibers & Polymer Materials, College of Chemistry, Chemical Engineering & Biotechnology, Donghua University, Shanghai, 201620, PR China
| | - Jiaqi Fan
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, PR China
- Department of Ophthalmology, Nanjing Medical University, Nanjing, 211166, PR China
| | - Huizi Jin
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, PR China
| | - Donghui Yu
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, PR China
| | - Sujing Qiang
- Department of Central Laboratory, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, PR China
| | - Chen Peng
- Cancer Center, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, PR China
| | - Jing Yu
- Department of Ophthalmology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200072, PR China
- Department of Ophthalmology, Ninghai First Hospital, Ninghai, Zhejiang, 315600, PR China
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Luo Z, Xu Y, Ye E, Li Z, Wu YL. Recent Progress in Macromolecule-Anchored Hybrid Gold Nanomaterials for Biomedical Applications. Macromol Rapid Commun 2019; 40:e1800029. [PMID: 29869424 DOI: 10.1002/marc.201800029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/12/2018] [Indexed: 12/16/2022]
Abstract
Gold nanoparticles (AuNPs), with elegant thermal, optical, or chemical properties due to quantum size effects, may serve as unique species for therapeutic or diagnostic applications. It is worth mentioning that their small size also results in high surface activity, leading to significantly impaired stability, which greatly hinders their biomedical utilizations. To overcome this problem, various types of macromolecular materials are utilized to anchor AuNPs so as to achieve advanced synergistic effect by dispersing, protecting, and stabilizing the AuNPs in polymeric-Au hybrid self-assemblies. In this review, the most recent development of polymer-AuNP hybrid systems, including AuNPs@polymeric nanoparticles, AuNPs@polymeric micelle, AuNPs@polymeric film, and AuNPs@polymeric hydrogel are discussed with respect to their different synthetic strategies. These sophisticated materials with diverse functions, oriented toward biomedical applications, are further summarized into several active domains in the areas of drug delivery, gene delivery, photothermal therapy, antibacterials, bioimaging, etc. Finally, the possible approaches for future design of multifunctional polymer-AuNP hybrids by combining hybrid chemistry with biological interface science are proposed.
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Affiliation(s)
- Zheng Luo
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, 361102, China
| | - Yang Xu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, 361102, China
| | - Enyi Ye
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Zibiao Li
- Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore, 138634, Singapore
| | - Yun-Long Wu
- Fujian Provincial Key Laboratory of Innovative Drug Target Research and State Key Laboratory of Cellular Stress Biology, School of Pharmaceutical Sciences, Xiamen University, Xiamen, 361102, China
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Yang Y, Zhou B, Zhou J, Shi X, Sha Y, Wu H. Assessment of lingual sentinel lymph nodes metastases using dual-modal indirect CT/MR lymphography with gold-gadolinium-based nanoprobes in a tongue VX 2 carcinoma model. Acta Otolaryngol 2018. [PMID: 29513120 DOI: 10.1080/00016489.2018.1441544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate the capability of indirect computed tomography and magnetic resonance lymphography (CT/MR-LG) with gadolinium-loaded, polyethylenimine-entrapped gold nanoprobes (Gd-Au PENPs) for assessing lingual sentinel lymph node (SLN) metastasis in a tongue VX2 carcinoma model. MATERIALS AND METHODS Seventeen rabbits were used to establish a metastatic cervical lymph node model by implanting VX2 carcinoma suspension into the ventral tongue muscle. CT and MR images were acquired one hour after Gd-Au PENPs injection into the tongue submucosa bilaterally, on 1w (n = 4), 2w (n = 6) and 3w (n = 7) tumour-bearing rabbits after carcinoma transplantation. Then, the filling defects and enhancement features of the lingual SLN on indirect CT/MR-LG were assessed. RESULTS The enhanced lingual SLNs were observed bilaterally in all rabbits using indirect CT/MR-LG. In total, 15 enhanced SLNs displayed oval or round shape with uniform density and no filling defects or only local small filling defects, and all nodes were metastasis-negative, while 19 enhanced SLNs demonstrated irregular morphologies with filling defects, non-uniform densities and unclear borders, of which 14 nodes were metastatic. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value when using SLN enhancement with irregular morphology, filling defects, non-uniform density and unclear border as diagnostic criteria for metastasis were 100%, 75.0%, 85.3%, 73.7% and 100%, respectively. CONCLUSIONS Indirect CT/MR-LG with Gd-Au PENPs can be used for the metastatic diagnosis of lingual SLN in tongue cancer.
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Affiliation(s)
- Yue Yang
- Departments of Otolaryngology-Head and Neck Surgery, Fudan University, Shanghai, China
- Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Benqing Zhou
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Jian Zhou
- Departments of Otolaryngology-Head and Neck Surgery, Fudan University, Shanghai, China
- Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Xiangyang Shi
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Yan Sha
- Departments of Radiology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Haitao Wu
- Departments of Otolaryngology-Head and Neck Surgery, Fudan University, Shanghai, China
- Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
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Jia J, Jia MQ, Zou HX. Lingual lymph nodes in patients with squamous cell carcinoma of the tongue and the floor of the mouth. Head Neck 2018; 40:2383-2388. [PMID: 30051610 DOI: 10.1002/hed.25340] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/26/2018] [Accepted: 05/07/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The treatment failure for oral squamous cell carcinoma (SCC) frequently takes the form of local and regional recurrences. We investigated the role of lingual lymph nodes (LLNs) in the recurrence of SCC of the tongue and the floor of the mouth. METHODS A total of 111 patients with SCC of the tongue and the floor of the mouth who received treatment between 2012 and 2017 were included in this study. The patients with lingual lymph nodes that were confirmed to be metastasis on pathological examination were classified into the LNN group. The demographic and clinical data differences between the No-LLN group and the LLN group were compared. Statistical analyses were performed using the Pearson chi-square test RESULTS: The total incidence of LLNs was 17.12% (19/111) and 5 patients (4.5%) demonstrated LLN metastases. All the patients with LLN metastases had a neck lymph node status of N2 classification. The incidence and metastasis of the LLNs were associated with pathological classifications of SCC of the tongue and the floor of the mouth. CONCLUSIONS LLNs are rare in patients with SCC of the tongue and the floor of the mouth, and they would be ready to be omitted. The dissection of these LLNs would be of benefit to those patients with advanced pathological grade.
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Affiliation(s)
- Jun Jia
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.,Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Meng-Qi Jia
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Hai-Xiao Zou
- Department of Stomatology, Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
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Novel Method to Detect Corneal Lymphatic Vessels In Vivo by Intrastromal Injection of Fluorescein. Cornea 2018; 37:267-271. [PMID: 29135605 DOI: 10.1097/ico.0000000000001444] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE Corneal lymphatic vessels are clinically invisible because of their thin walls and clear lymph fluid. There is no easy and established method for in vivo imaging of corneal lymphatic vessels so far. In this study, we present a novel approach to visualize corneal lymphatic vessels in vivo by injecting intrastromal fluorescein sodium. METHODS Six- to eight-week-old female BALB/c mice were used in the mouse model of suture-induced corneal neovascularization. Two weeks after the suture placement, fluorescein sodium was injected intrastromally. The fluorescein, taken up by the presumed lymphatic vessels, was then tracked using a clinically used Spectralis HRA + OCT device. Immunohistochemistry staining with specific lymphatic marker LYVE-1 and pan-endothelial marker CD31 was used to confirm the indirect lymphangiography findings. RESULTS By injecting fluorescein intrastromally, both corneal blood and lymphatic vessels were detected. While the lymphatic vessels were visible as bright vessel-like structures using HRA, the blood vessels appeared as dark networks. Fluorescein-labeled lymphatic vessels were colocalized with LYVE-1 in immunohistochemically stained sections of the same specimen. CONCLUSIONS Corneal lymphatic vessels can be easily imaged in vivo in the murine model using intrastromal fluorescein injection.
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Diagnostic value of sentinel lymph node biopsy for cT1/T2N0 tongue squamous cell carcinoma: a meta-analysis. Eur Arch Otorhinolaryngol 2017; 274:3843-3852. [PMID: 28900723 DOI: 10.1007/s00405-017-4740-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 09/06/2017] [Indexed: 02/05/2023]
Abstract
The aim of this study was to systematically evaluate the diagnostic value of the sentinel lymph node biopsy (SLNB) for cT1/T2N0 tongue squamous cell carcinoma (TSCC) patients. A comprehensive and systematic literature review was performed by searching the Embase and PubMed databases for English language articles published up to December 2016. The pooled overall sentinel lymph node (SLN) detection rate, sensitivity and negative predictive value (NPV) were used to evaluate the diagnostic value of SLNB which used neck dissection or follow-up as a reference test. The Q test and I 2 statistic were used to assess the heterogeneity across the studies. Subgroup analyses were performed in consideration of higher contribution of different clinical characteristics on the SLNB diagnostic value. Begg's linear regression and Egger's regression tests were conducted to evaluate the publication bias. Thirty-five studies (with 1084 patients) were included. The pooled SLN detection rate was 98% (95% CI 97-100%). The pooled overall sensitivity and NPV of SLNB were 0.92 (95% CI 0.88-0.95) and 0.96 (95% CI 0.94-0.97), respectively. The subgroup analyses demonstrated that higher extracted number of patients (n ≥ 30) from the included studies achieved a more stable NPV than lower number of patients. SLNB can effectively predict the status of regional lymph nodes in cT1/T2N0 TSCC patients. With high sensitivity and NPV, SLNB can guide the treatment of SLNB-positive patients with neck dissections and those with negative SLNBs with follow-ups in order to avoid unnecessary surgical morbidity.
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