Usefulness of CT-lymphography in sentinel lymph node navigation.

Abstract

BACKGROUND:

There are many methods for sentinel lymph node (SLN) navigation. The methods using radioisotopes and blue dyes are performed mainly for the identification of SLN. Our current method for SLN biopsy is a combination of three techniques with 99mTc-phytate, patent blue V dye, and preoperative CT-lymphography (CTLG).

PATIENTS AND METHODS:

Iomeprol (Iomeron®) as a water-soluble contrast agent is diluted twofold with 1 % lidocaine and intradermally injected into a few sites (2-5 ml at each site) around the tumor. After the injection, CT imaging is performed using a 64-row MDCT system (Siemens SOMATOM Definition AS+). We performed CTLG in 34 patients (16 men, 18 women) between September 2008 and March 2013.

RESULTS:

CTLG clearly visualized the SLN and the lymphatic drainage in 21 out of 34 patients.

CONCLUSIONS:

We can detect the SLN and lymphatic flow near to tumors without shine-through effect, especially in the head and neck regions. It is thought that CTLG may be useful to determine the range of lymph node dissection.

• Authors: Masato Yasuta, Suguru Sato, Tomokazu Ishida, Takahiro Kiyohara
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 19 Issue 3 Pg. 557-562 ( 2014) ISSN: 1437-7772 [Electronic] Japan
• PMID: 23797211 (Publication Type: Case Reports, Journal Article)

Chemical References

• iomeprol
• Iopamidol

Topics

• Adult
• Aged
• Carcinoma, Squamous Cell (pathology)
• Cheek (pathology)
• Female
• Humans
• Iopamidol (analogs & derivatives)
• Lymphography (methods)
• Male
• Melanoma (pathology)
• Middle Aged
• Paget Disease, Extramammary (pathology)
• Sentinel Lymph Node Biopsy (methods)
• Tomography, X-Ray Computed (methods)
• Vulvar Neoplasms (pathology)