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Mahieu R, Donders DNV, Dankbaar JW, de Bree R, de Keizer B. CT Lymphography Using Lipiodol® for Sentinel Lymph Node Biopsy in Early-Stage Oral Cancer. J Clin Med 2022; 11:jcm11175129. [PMID: 36079061 PMCID: PMC9456579 DOI: 10.3390/jcm11175129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 08/27/2022] [Accepted: 08/28/2022] [Indexed: 11/18/2022] Open
Abstract
This study evaluated sentinel lymph node (SLN) identification with CT lymphography (CTL) following peritumoral administration of Lipiodol® relative to conventional 99mTc-nanocolloid lymphoscintigraphy (including SPECT/CT) in 10 early-stage oral cancer patients undergoing SLN biopsy. Patients first underwent early dynamic and static scintigraphy after peritumoral administration of 99mTc-nanocolloid. Subsequently, Lipiodol® was administered at the same injection sites, followed by fluoroscopy and CT acquisition. Finally, late scintigraphy and SPECT/CT were conducted, enabling the fusion of late CTL and SPECT imaging. The next day, designated SLNs were harvested, radiographically examined for Lipiodol® uptake and histopathologically assessed. Corresponding images of CT, 99mTc-nanocolloid lymphoscintigraphy and SPECT/late CTL fusion were evaluated. 99mTc-nanocolloid lymphoscintigraphy identified 21 SLNs, of which 7 were identified with CTL (33%). CTL identified no additional SLNs and failed to identify any SLNs in four patients (40%). Out of six histopathologically positive SLNs, two were identified by CTL (33%). Radiographic examination confirmed Lipiodol® uptake in seven harvested SLNs (24%), of which five were depicted by CTL. CTL using Lipiodol® reached a sensitivity of 50% and a negative predictive value (NPV) of 75% (median follow-up: 12.3 months). These results suggest that CTL using Lipiodol® is not a reliable technique for SLN mapping in early-stage oral cancer.
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Affiliation(s)
- Rutger Mahieu
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Dominique N. V. Donders
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Jan Willem Dankbaar
- Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Correspondence: ; Tel.: +31-887550819
| | - Bart de Keizer
- Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Department of Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
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Luo L, Zhang B. Adoption of Computed Tomography Image via Nano Contrast Agent in the Diagnosis and Treatment of Arrhythmia Patients. J Biomed Nanotechnol 2022. [DOI: 10.1166/jbn.2022.3398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
To explore the function and specific adoption of nano contrast agent in computed tomography (CT) images of patients with arrhythmia. In this study, the control group received general CT examination, and the test group received preoperative injection of nano contrast agent. All patients
were scanned by retrospective electrocardiogram (ECG)-gated helical scanning, after which the coronary artery reconstruction and analysis were performed in a dedicated image post-processing workstation. Compared with the control group, there were decreases in heart rate variability, multistage
reconstruction requirement, ECG editing requirement, and the undiagnosed segment ratio during CT scanning in the test group, while the proportion of diagnosable segments and diagnosable patients increased; the average duration of CT image postprocessing in the test group was higher than that
in the control group. The nano contrast agent could improve the quality of CT images of some patients with arrhythmia, and the improvement was different in patients with different types of arrhythmia. The overall CT image quality and post-processing of patients with arrhythmia were improved
by nano contrast agent, and this experiment laid a foundation for the clinical adoption of nano contrast agent in CT image detection and pointed out the direction for subsequent clinical research.
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Affiliation(s)
- Lidan Luo
- Department of Hepatology, Hunan Provincial People’s Hospital, Changsha, 410005, PR China
| | - Bin Zhang
- Department of Radiology, Xiangya Second Hospital, Central South University, Changsha, 410005, PR China
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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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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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Dendrimer-Entrapped Gold Nanoparticles as Potential CT Contrast Agents for Localizing Sentinel Lymph Node via Indirect CT Lymphography on Rabbit Model. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1230151. [PMID: 29850482 PMCID: PMC5932527 DOI: 10.1155/2018/1230151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 01/04/2018] [Indexed: 01/15/2023]
Abstract
Objective To investigate the potential use of indirect computed tomography lymphography (CT-LG) with dendrimer-entrapped gold nanoparticles (Au DENPs) in the localization and enhanced imaging of cervical sentinel lymph node (SLN) on rabbit model. Methods Twelve rabbits were randomly divided into two groups: the positive control group and the experimental group. In the control group, indirect CT-LG was performed with the injection of 0.5 ml activated carbon nanoparticles (ACNP) and Omnipaque mixture suspension in the right tongue submucosa. CT images were acquired before the injection and 1, 5, 10, and 15 min after the injection, respectively. In the experimental group, indirect CT-LG injection with 0.5 ml Au DENPs suspension was performed in the right tongue submucosa. CT images were obtained before the injection and 1, 5, 10, and 15 min and 1, 2, 6, 24, 48, and 72 h after the injection, respectively. Then, SLN identification and enhancement characteristics were evaluated. Results Indirect CT-LG revealed the enhancement of one right deep cervical lymph nodes in all animals, which was SLN. SLN location was marked with black color (ACNP dye) or purple-black color (Au DENPs dye). At each detection time point, the enhanced SLN attenuation values of control rabbits were statistically significantly higher than that of the plain scan, respectively (P < 0.05). Also the values of experimental rabbits were statistically significantly higher than that of the control at the same time point after injection (P < 0.05). The detection rate of SLN was 100%. Conclusions Indirect CT-LG with injection of Au DENPs as CT contrast agents can locate the SLN for a long period of time and enrich the SLN black dye. It is helpful for SLNs identification during the operation.
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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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