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Eiger SN, Bertran J, Reynolds PS, Regier P, Case JB, Ham K, Mison M, Fox-Alvarez WA. Use of near-infrared fluorescence angiography with indocyanine green to evaluate direct cutaneous arteries used for canine axial pattern flaps. Vet Surg 2024. [PMID: 38837285 DOI: 10.1111/vsu.14121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/06/2024] [Accepted: 05/19/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To describe the use of near-infrared angiography (NIRFA) to identify the vascularization of three canine axial pattern flaps (APFs) omocervical (OMO), thoracodorsal (THO), and caudal superficial epigastric (CSE); to establish a vascular fluorescence pattern (VFP) grading system; and to evaluate the effect of NIRFA on surgeon flap dimension planning compared to traditional landmark palpation (LP) and visualization assessments. STUDY DESIGN Experimental study. ANIMALS A total of 15 healthy, client-owned dogs. METHODS Dogs were sedated and flap sites were clipped. LP-based margins were drawn and preinjection images were recorded. Indocyanine green (ICG) was administered and VFP images were recorded. VFP scores were determined by five surgeons. Margin alterations were performed based on NIRFA-ICG images. Altered measurements were compared between LP and NIRFA-ICG images. RESULTS Vascularization of the CSE flap was most visible with NIRFA with VFP scores 4/4 for 13/15 dogs. Intersurgeon agreement for VFP grades was poorest for THO (ICC = 0.35) and intermediate for OMO (ICC = 0.49) flaps. Surgeons were more likely to adjust dimensions for CSE flaps relative to OMO (OR 17.3, 95% CI: 6.2, 47.8) or THO (25.5; 8.6, 75.7). CONCLUSION Using a grading system, we demonstrated that the CSE flap was most visible. Surgeons were more likely to adjust the LP-CSE flap margins based on fluorescence patterns and were more likely to rely on LP when visualization scores were low. CLINICAL SIGNIFICANCE NIRFA has possible applications identifying some direct cutaneous arteries of APFs and their associated angiosomes in real-time. Further investigation is indicated to study NIRFA's potential to improve patient specific APF planning.
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Affiliation(s)
- Sophie N Eiger
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Judit Bertran
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Penny S Reynolds
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Penny Regier
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - J Brad Case
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Kathleen Ham
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Michael Mison
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - W Alexander Fox-Alvarez
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Stefanello D, Gariboldi EM, Boracchi P, Ferrari R, Ubiali A, De Zani D, Zani DD, Grieco V, Giudice C, Recordati C, Caniatti M, Auletta L, Chiti LE. Weishaar's classification system for nodal metastasis in sentinel lymph nodes: Clinical outcome in 94 dogs with mast cell tumor. J Vet Intern Med 2024; 38:1675-1685. [PMID: 38426589 PMCID: PMC11099738 DOI: 10.1111/jvim.16997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The therapeutic role and prognostic relevance of lymphadenectomy in mast cell tumor (MCT) has historically been evaluated on regional rather than sentinel lymph nodes. HYPOTHESIS/OBJECTIVES To update information about the association of histological nodal (HN) classes with clinical outcome in dogs with MCT after tumor excision and extirpation of normal-sized sentinel nodes (SLN) guided by radiopharmaceutical. ANIMALS Ninety-four dogs with histologically-confirmed treatment-naïve MCT (71 cutaneous, 22 subcutaneous and 1 conjunctival MCT) were included if without: distant metastases, lymphadenomegaly, concurrent mixed cutaneous, and subcutaneous MCT. METHODS This was a monoistitutional cohort study. Tumors characteristics were retrieved and SLNs were classified according to Weishaar's system. Incidence of MCT-related events (local, nodal, distant relapse), de novo MCT or other tumors and death (MCT-related and non-MCT-related), were recorded. Incidence curves were compared among the HN classes. RESULTS Twenty-seven dogs had HN0, 19 HN1, 37 HN2, and 11 HN3 SLN. Thirteen (2 HN0, 4 HN2, and 7 HN3) received adjuvant chemotherapies. Kiupel high grade, increasing number of SLN and lymphocentrums were associated with higher HN classes. Five dogs died for MCT-related causes: 1 low-grade (HN0) and 1 subcutaneous (HN3) had a local relapse, 2 high-grade had distant relapse (HN3-HN0) and 1 dog developed disease progression from a de novo subcutaneous MCT. No nodal relapse was registered. Fourteen dogs developed de novo MCTs. CONCLUSION/DISCUSSION Low grade/low-risk MCT with nonpalpable and normal sized SLN have a favorable outcome independently from the HN. Result should be considered strictly related to the successful SLN detection guided pre- and intraoperative by radiopharmaceutical markers.
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Affiliation(s)
- Damiano Stefanello
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Elisa M. Gariboldi
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Patrizia Boracchi
- Dipartimento di Scienze Biomediche e ClinicheUniversità degli Studi di MilanoMilanoItaly
| | - Roberta Ferrari
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Alessandra Ubiali
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Donatella De Zani
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Davide D. Zani
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Valeria Grieco
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Chiara Giudice
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Camilla Recordati
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Mario Caniatti
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Luigi Auletta
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
| | - Lavinia E. Chiti
- Dipartimento di Medicina Veterinaria e Scienze AnimaliUniversità degli Studi di MilanoLodiItaly
- Clinic for Small Animals Surgery—Vetsuisse FacultyUniversity of ZurichZurichSwitzerland
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Romańska M, Degórska B, Zabielska-Koczywąs KA. The Use of Sentinel Lymph Node Mapping for Canine Mast Cell Tumors. Animals (Basel) 2024; 14:1089. [PMID: 38612328 PMCID: PMC11010880 DOI: 10.3390/ani14071089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Cancer is the leading cause of death in companion animals. The evaluation of locoregional lymph nodes, known as lymph node mapping, is a critical process in assessing the stage of various solid tumors, such as mast cell tumors (MCTs), anal gland anal sac adenocarcinoma, melanoma, and mammary gland adenocarcinoma. MCTs are among the most prevalent skin malignancies in dogs. Staging is used to describe the extent of neoplastic disease, provide a framework for rational treatment planning, and evaluate treatment results. The aim of this review is to present the current knowledge on sentinel lymph node (SLN) mapping in canine MCTs, its influence on treatment decisions and prognosis, as well as the advantages and limitations of different SLN techniques currently available in veterinary oncology. A search methodology was adopted using the PubMed, Scopus, and Google Scholar databases. Critical analyses of up-to-date research have shown that lymphoscintigraphy can achieve a lymph node detection rate of between 91 and 100%. This method is becoming increasingly recognized as the gold standard in both human and veterinary medicine. In addition, initial studies on a limited number of animals have shown that computed tomographic lymphography (CTL) is highly effective in the SLN mapping of MCTs, with detection rates between 90 and 100%. The first study on contrast-enhanced ultrasound (CEUS) also revealed that this advanced technique has up to a 95% detection rate in canine MCTs. These methods provide non-ionizing alternatives with high detection capabilities. Furthermore, combining computed tomography and near-infrared fluorescence (NIR/NIR-LND) lymphography is promising as each technique identifies different SLNs. Indirect lymphography with Lipiodol or Iohexol is technically feasible and may be also used to effectively detect SLNs. The integration of these mapping techniques into routine MCT staging is essential for enhancing the precision of MCT staging and potentially improving therapeutic outcomes. However, further clinical trials involving a larger number of animals are necessary to refine these procedures and fully evaluate the clinical benefits of each technique.
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Affiliation(s)
| | | | - Katarzyna A. Zabielska-Koczywąs
- Department of Small Animal Diseases and Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences, Nowoursynowska 159c, 02-776 Warsaw, Poland; (M.R.); (B.D.)
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Annoni M, Borgonovo S, Aralla M. Sentinel lymph node mapping in canine mast cell tumours using a preoperative radiographic indirect lymphography: Technique description and results in 138 cases. Vet Comp Oncol 2023; 21:469-481. [PMID: 37191042 DOI: 10.1111/vco.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 04/26/2023] [Accepted: 05/02/2023] [Indexed: 05/17/2023]
Abstract
Several sentinel lymph node (SLN) mapping techniques, to detect nodal metastasis in canine tumours have been investigated in the last 10 years in veterinary oncology. The purpose of this prospective study was to describe a reliable, quick, and inexpensive technique for SLN mapping in canine patients affected by cutaneous and subcutaneous mast cell tumours (MCT). Eighty dogs were enrolled in this study for a total of 138 cytologically diagnosed MCTs. Sentinel lymph node mapping was performed by injecting iomeprole peritumorally followed by serial radiographs at 1, 3, 6 and 9-min post injection. A total of 168 SLNs were detected, 90% at first radiograph, 1 min after the peritumoral iomeprole injection, while in the rest of the cases SLN was identified at 3 min. Sentinel lymph nodes detected by the preoperative radiographic indirect lymphography with iomeprole (PRILI) differed from regional lymph nodes in 57% of cases. The PRILI technique detected simultaneously multiple SLNs in the 26% of cases and multiple lymph centers in the 31% of MCTs. To allow the surgical identification of the SLNs, a peritumoral injection of methylene blue was performed at the time of surgery. This study reports a widely available technique for SLN mapping using digital radiographs in combination with a water-soluble medium, representing a cost-effective alternative to other SLN mapping procedures. Based on our results, this technique can be effective for SLNs mapping in dogs with MCTs but further comparative studies are needed to assess its reliability and efficacy in different tumours.
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Affiliation(s)
- Maurizio Annoni
- Department of Soft Tissue and Oncologic Surgery, AniCura Clinica Veterinaria Tibaldi, Milan, Italy
| | - Simone Borgonovo
- Department of Diagnostic Imaging, AniCura Clinica Veterinaria Tibaldi, Milan, Italy
| | - Marina Aralla
- Department of Oncology, Pronto Soccorso Veterinario Laudense, Lodi, Milan, Italy
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Chiti LE, Park B, d'Orchymont F, Holland JP, Nolff MC. Impact of Surgical Lights on the Performance of Fluorescence-Guided Surgery Systems: A Pilot Study. Animals (Basel) 2023; 13:2363. [PMID: 37508142 PMCID: PMC10376740 DOI: 10.3390/ani13142363] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/16/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Fluorescence-guided surgery can aid in the intraoperative visualization of target tissues, with promising applications in human and veterinary surgical oncology. The aim of this study was to evaluate the performances of two fluoresce camera systems, IC-FlowTM and VisionsenseTM VS3 Iridum, for the detection of two non-targeted (ICG and IRDye-800) and two targeted fluorophores (AngiostampTM and FAP-Cyan) under different room light conditions, including ambient light, new generation LED, and halogen artificial light sources, which are commonly used in operating theaters. Six dilutions of the fluorophores were imaged in phantom kits using the two camera systems. The limit of detection (LOD) and mean signal-to-background ratio (mSBR) were determined. The highest values of mSBR and a lower LOD were obtained in dark conditions for both systems. Under room lights, the capabilities decreased, but the mSBR remained greater than 3 (=clearly detectable signal). LOD and mSBR worsened under surgical lights for both camera systems, with a greater impact from halogen bulbs on VisionsenseTM VS3 Iridium and of the LED lights on IC-Flow due to a contribution of these lights in the near-infrared spectrum. When considering implementing FGS into the clinical routine, surgeons should cautiously evaluate the spectral contribution of the lights in the operating theater.
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Affiliation(s)
- Lavinia E Chiti
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Wintherturerstrasse 260, CH-8057 Zurich, Switzerland
| | - Brian Park
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Wintherturerstrasse 260, CH-8057 Zurich, Switzerland
| | - Faustine d'Orchymont
- Department of Chemistry, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland
| | - Jason P Holland
- Department of Chemistry, University of Zurich, Winterthurerstrasse 190, CH-8057 Zurich, Switzerland
| | - Mirja C Nolff
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Wintherturerstrasse 260, CH-8057 Zurich, Switzerland
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Gariboldi EM, Ubiali A, Chiti LE, Ferrari R, De Zani D, Zani DD, Grieco V, Giudice C, Recordati C, Stefanello D, Auletta L. Evaluation of Surgical Aid of Methylene Blue in Addition to Intraoperative Gamma Probe for Sentinel Lymph Node Extirpation in 116 Canine Mast Cell Tumors (2017-2022). Animals (Basel) 2023; 13:1854. [PMID: 37889797 PMCID: PMC10251889 DOI: 10.3390/ani13111854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 10/29/2023] Open
Abstract
Methylene Blue (MB) is combined with radiopharmaceutical for intraoperative sentinel lymph node (SLN) mapping, but its role during SLN extirpation has not been investigated yet in veterinary medicine. The aim of this study was to assess whether MB increased surgical detection of SLN beyond the use of intraoperative gamma-probe (IGP) alone in clinically node-negative dogs with mast cell tumors (MCTs) following the detection of sentinel lymphocentrums (SLCs) via preoperative planar lymphoscintigraphy. Dogs enrolled underwent MCT excision and SLC exploration guided by both MB and IGP. Data recorded for each SLN were staining (blue/non-blue), radioactivity (hot/non-hot), and histopathological status (HN0-1 vs. HN2-3). A total of 103 dogs bearing 80 cutaneous, 35 subcutaneous, and 1 mucocutaneous MCTs were included; 140 SLCs were explored, for a total of 196 SLNs removed. Associating MB with IGP raised the SLNs detection rate from 90% to 95%. A total of 44% of SLNs were metastatic: 86% were blue/hot, 7% were only blue, 5% were only hot, and 2% were non-blue/non-hot. All HN3 SLNs were hot. Combining MB with IGP can increase the rate of SLN detection in dogs with MCTs; nonetheless, all lymph nodes identified during dissection should be removed, as they might be unstained but metastatic.
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Affiliation(s)
- Elisa Maria Gariboldi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Alessandra Ubiali
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Lavinia Elena Chiti
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
- Clinic for Small Animals Surgery, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland
| | - Roberta Ferrari
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Donatella De Zani
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Davide Danilo Zani
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Valeria Grieco
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Chiara Giudice
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Camilla Recordati
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Luigi Auletta
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
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Chiti LE, Husi B, Park B, Beer P, D'Orchymont F, Holland JP, Nolff MC. Performance of two clinical fluorescence imaging systems with different targeted and non-targeted near-infrared fluorophores: a cadaveric explorative study. Front Vet Sci 2023; 10:1091842. [PMID: 37138917 PMCID: PMC10149874 DOI: 10.3389/fvets.2023.1091842] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction Near-infrared (NIR) fluorescence-guided surgery is increasingly utilized in humans and pets. As clinical imaging systems are optimized for Indocyanine green (ICG) detection, the usage of targeted dyes necessitates the validation of these systems for each dye. We investigated the impact of skin pigmentation and tissue overlay on the sensitivity of two NIR cameras (IC-FlowTM, VisionsenseTM VS3 Iridum) for the detection of non-targeted (ICG, IRDye800) and targeted (AngiostampTM, FAP-Cyan) NIR fluorophores in an ex vivo big animal model. Methods We quantitatively measured the limit of detection (LOD) and signal-to-background ratio (SBR) and implemented a semi-quantitative visual score to account for subjective interpretation of images by the surgeon. Results VisionsenseTM VS3 Iridum outperformed IC-FlowTM in terms of LOD and SBR for the detection of all dyes except FAP-Cyan. Median SBR was negatively affected by skin pigmentation and tissue overlay with both camera systems. Level of agreement between quantitative and semi-quantitative visual score and interobserver agreement were better with VisionsenseTM VS3 Iridum. Conclusion The overlay of different tissue types and skin pigmentation may negatively affect the ability of the two tested camera systems to identify nanomolar concentrations of targeted-fluorescent dyes and should be considered when planning surgical applications.
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Affiliation(s)
- Lavinia E. Chiti
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Zurich, Switzerland
- *Correspondence: Lavinia E. Chiti
| | - Benjamin Husi
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Zurich, Switzerland
| | - Brian Park
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Zurich, Switzerland
| | - Patricia Beer
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Zurich, Switzerland
| | | | - Jason P. Holland
- Department of Chemistry, University of Zurich, Zurich, Switzerland
| | - Mirja C. Nolff
- Klinik für Kleintierchirurgie, Vetsuisse-Fakultät, University of Zurich, Zurich, Switzerland
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Arz R, Chiti LE, Krudewig C, Grieco V, Meier V, Fejös C, Stefanello D, Nolff MC. Lymph node metastasis in feline cutaneous low-grade mast cell tumours. J Feline Med Surg 2023; 25:1098612X221138468. [PMID: 36638145 PMCID: PMC10812050 DOI: 10.1177/1098612x221138468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES This retrospective study aimed to determine the incidence of nodal metastatic disease in cats affected by low-grade cutaneous mast cell tumours (MCTs) in our study population. METHODS The clinical records of two centres were retrospectively searched for cats with cutaneous MCTs that had undergone lymphadenectomy of enlarged and non-enlarged lymph nodes. All primary tumours were histologically reviewed by two experienced pathologists and graded as high- or low-grade based on the grading system for feline cutaneous MCT. We graded the lymph nodes based on the grading scheme used for canine MCTs and considered HN2 and HN3 nodes to be metastatic. The number of patients with nodal metastasis was calculated. RESULTS We identified 17 cats with cutaneous MCT resection and concurrent lymphadenectomy. All 21 MCTs were graded as low grade and 30 nodes were removed, with 12 being considered early or overtly metastatic (HN2 or HN3, respectively). Based on nodal status, 10/17 (59%) cats were affected by nodal metastasis in our population. CONCLUSIONS AND RELEVANCE In contrast to previous reports, high percentage of cats with cutaneous MCTs in which lymphadenectomy was performed were presented with metastatic lymph nodes. The clinical relevance of this finding and a potential benefit of lymphadenectomy must be determined in future studies.
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Affiliation(s)
- Raphael Arz
- Clinic for Small Animal Surgery, Department for Small Animals, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Lavinia E Chiti
- Clinic for Small Animal Surgery, Department for Small Animals, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Christiane Krudewig
- Institute of Veterinary Pathology, Department for Small Animals, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Valeria Grieco
- Department of Veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Valeria Meier
- Division of Radiation Oncology, Department for Small Animals, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Csilla Fejös
- Division of Radiation Oncology, Department for Small Animals, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Science, University of Milan, Lodi, Italy
| | - Mirja C Nolff
- Clinic for Small Animal Surgery, Department for Small Animals, Vetsuisse Faculty, University of Zurich, Switzerland
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Chiti LE, Gariboldi EM, Stefanello D, De Zani D, Grieco V, Nolff MC. Sentinel Lymph Node Mapping and Biopsy in Cats with Solid Malignancies: An Explorative Study. Animals (Basel) 2022; 12:3116. [PMID: 36428344 PMCID: PMC9686746 DOI: 10.3390/ani12223116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 11/15/2022] Open
Abstract
There is increasing evidence on the utility of sentinel lymph node (SLN) biopsy (SLNB) for the staging of dogs with various malignancies; however, comparable information is missing in cats. This multi-institutional study aims at reporting the feasibility and detection rate of SLNB guided by lymphoscintigraphy and the blue dye or near-infrared fluorescent lymphography (NIRF-L) in cats with solid tumors. In total, 12 cats presented with 14 solid malignancies that underwent curative-intent surgical excision of the primary tumor and SLNB were retrospectively enrolled. The mapping technique used, location and number of SLN, correspondence with the regional lymph node (RLN), and histological status of the SLN were retrieved. The detection rate and complications of SLNB were also recorded. NIRF-L was performed in 64.3% of tumors and lymphoscintigraphy in 35.7%. The detection rate was 100% for both techniques. The SLN did not correspond (fully or partially) to the RLN in 71.4% of cases, with multiple SLN being excised in 9/14 tumors. No complications related to SLNB were recorded. At histopathology, metastases were identified in 41.7% of cats, all with mast cell tumors (MCT). SLNB guided by NIRF-L or lymphoscintigraphy is feasible and safe in cats with solid tumors and should be suggested for correct tumor staging in cats, especially with MCT.
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Affiliation(s)
- Lavinia Elena Chiti
- Clinic for Smal Animals Surgery, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland
| | - Elisa Maria Gariboldi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Donatella De Zani
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Valeria Grieco
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy
| | - Mirja Christine Nolff
- Clinic for Smal Animals Surgery, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland
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Sentinel Lymph Node Biopsy Is Feasible in Dogs with Scars from Prior Local Excision of Solid Malignancies. Animals (Basel) 2022; 12:ani12172195. [PMID: 36077914 PMCID: PMC9454906 DOI: 10.3390/ani12172195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Sentinel lymph node (SLN) excision is gaining relevance in the management of various canine malignancies due to its recognized impact on staging and treatment choices. However, the technologies to perform SLN mapping are only available to a few referral centers, and there is increasing demand for secondary nodal staging after prior tumor excision at the primary care institution. This retrospective study investigated the feasibility and usefulness of SLN biopsy in dogs with surgical scars resulting from the removal of various solid tumors referred for further staging and/or adjuvant treatment options. Thirty-three dogs with 34 scars underwent SLN biopsy at a median of 50 days after primary tumor excision. An SLN was identified for 31/34 scars, translating to a detection rate of 91.2%. Metastases were identified with histopathology in 13/31 dogs (41.9%) and they all had an excision of a mast cell tumor. SLN biopsy should be suggested in dogs presenting with scars from prior solid tumor excision, considering the observed detection rate and the importance of knowing the metastatic status of the SLN in oncological diseases. Abstract Sentinel lymph node (SLN) biopsy is a well-established staging tool in canine oncology. This study aims to explore the feasibility of SLN biopsy in dogs with scars from prior excised solid malignancies that were referred for further tumor staging and/or adjuvant treatment options. Mapping was either performed using radiopharmaceutical, methylene blue, and/or near-infrared fluorescent (NIRF) imaging. Thirty-three dogs with 34 scars from prior excision of the mast cell tumor (MCT) (n = 29), soft tissue sarcoma (n = 2), oral melanoma (n = 1), subungual melanoma (n = 1), and mammary adenocarcinoma (n = 1) were retrospectively enrolled. Primary treatment consisted of curative intent/wide tumor excisions in 50.0% of dogs and marginal excision in the remaining 50.0%. The median time between tumor excision and SLN biopsy was 50 days (range 17–110 days). The procedure was successful in 31/34 scars, translating to a detection rate of 91.2%. The SLN did not correspond to the regional lymph node in 19/31 scars (61.3%). SLN metastases were histologically identified in 13/31 (41.9%) dogs, all of them affected by MCT. Based on our results, SLN biopsy using lymphoscintigraphy/methylene blue and/or NIRF is feasible in dogs presenting with scars from the prior surgical excision of solid tumors, and should be suggested for accurate nodal staging.
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