Hostname: page-component-7479d7b7d-fwgfc Total loading time: 0 Render date: 2024-07-15T21:16:13.692Z Has data issue: false hasContentIssue false

Assessment of cervical lymph node metastases using indirect computed tomography lymphography with iopamidol in a tongue VX2 carcinoma model

Published online by Cambridge University Press:  31 May 2011

Y Shu
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
X Xu
Affiliation:
Department of Otolaryngology, Shanghai Seventh People's Hospital, Fudan University, Shanghai, China
Z Wang
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
W Dai
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
Y Zhang
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
Y Yu
Affiliation:
Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
Y Sha
Affiliation:
Department of Radiology, Eye and ENT Hospital, Fudan University, Shanghai, China
H Wu*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China
*
Address for correspondence: Dr Haitao Wu, 83 FenYang Road, Shanghai 200031, PR China Fax: +086 21 64377151 E-mail: Haitaowu1103@hotmail.com

Abstract

Objective:

To investigate the performance of indirect computed tomography lymphography with iopamidol for detecting cervical lymph node metastases in a tongue VX2 carcinoma model.

Materials and methods:

A metastatic cervical lymph node model was created by implanting VX2 carcinoma suspension into the tongue submucosa of 21 rabbits. Computed tomography images were obtained 1, 3, 5, 10, 15 and 20 minutes after iopamidol injection, on days 11, 14, 21 (six rabbits each) and 28 (three rabbits) after carcinoma transplantation. Computed tomography lymphography was performed, and lymph node filling defects and enhancement characteristics evaluated.

Results:

Indirect computed tomography lymphography revealed bilateral enhancement of cervical lymph nodes in all animals, except for one animal imaged on day 28. There was significantly slower evacuation of contrast in metastatic than non-metastatic nodes. A total of 41 enhanced lymph nodes displayed an oval or round shape, or local filling defects. One lymph node with an oval shape was metastatic (one of 11, 9.1 per cent), while 21 nodes with filling defects were metastatic (21/30, 70 per cent). The sensitivity, specificity, accuracy, and positive and negative predictive values when using a filling defect diameter of 1.5 mm as a diagnostic criterion were 86.4, 78.9, 82.9, 82.6 and 83.3 per cent, respectively.

Conclusion:

When using indirect computed tomography lymphography to detect metastatic lymph nodes, filling defects and slow evacuation of contrast agent are important diagnostic features.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Barrett, T, Choyke, PL, Kobayashi, H. Imaging of the lymphatic system: new horizons. Contrast Media Mol Imaging 2006;1:230–45CrossRefGoogle ScholarPubMed
2Chen, J, Cheong, JH, Yun, MJ, Kim, J, Lim, JS, Hyung, WJ et al. Improvement in preoperative staging of gastric adenocarcinoma with positron emission tomography. Cancer 2005;103:2383–90Google Scholar
3Ng, SH, Yen, TC, Liao, CT, Chang, JTC, Chan, SC, Ko, SF et al. F-18-FDG PET and CT/MRI in oral cavity squamous cell carcinoma: a prospective study of 124 patients with histologic correlation. J Nucl Med 2005;46:1136–43Google Scholar
4Russell, M, Anzai, Y. Ultrasmall superparamagnetic iron oxide enhanced MR imaging for lymph node metastases. Radiography 2007;13(Supplement 1):e73–84Google Scholar
5Schoder, H, Carlson, DL, Kraus, DH, Stambuk, HE, Gonen, M, Erdi, YE et al. F-18-FDG PET/CT for detecting nodal metastases in patients with oral cancer staged N0 by clinical examination and CT/MRI. J Nucl Med 2006;47(5):755–62Google Scholar
6Wunderbaldinger, P. Problems and prospects of modern lymph node imaging. Eur J Radiol 2006;58:325–37Google Scholar
7Witte, CL, Williams, WH, Witte, MH. Lymphatic, imaging. Lymphology 1993;26:109–11Google Scholar
8Guermazi, A, Brice, P, Hennequin, C, Sarfati, E. Lymphography: an old technique retains its usefulness. Radiographics 2003;23:1541–58CrossRefGoogle ScholarPubMed
9Wolf, GL, Rogowska, J, Hanna, GK, Halpern, EF. Percutaneous CT lymphography with Perflubron – imaging efficacy in rabbits and monkeys. Radiology 1994;191:501–5Google Scholar
10Wisner, ER, Katzberg, RW, Link, DP, Griffey, SM, Drake, CM, Vessey, AR et al. Indirect computed tomography lymphography using iodinated nanoparticles to detect cancerous lymph nodes in a cutaneous melanoma model. Acad Radiol 1996;3:40–8Google Scholar
11Jiang, DY, Gazelle, GS, Wolf, GL. A model of focal cancer in rabbit lymph nodes. Acad Radiol 1996;3:159–62Google Scholar
12Takahashi, M, Sasa, M, Hirose, C, Hisaoka, S, Taki, M, Hirose, T et al. Clinical efficacy and problems with CT lymphography in identifying the sentinel node in breast cancer. World J Surg Oncol 2008;6:57Google Scholar
13Suga, K, Shimizu, K, Kawakami, Y, Tangoku, A, Zaki, M, Matsunaga, N et al. Lymphatic drainage from esophagogastric tract: feasibility of endoscopic CT lymphography for direct visualization of pathways. Radiology 2005;237:952–60Google Scholar
14Ueda, K, Suga, K, Kaneda, Y, Li, TS, Ueda, K, Hamano, K. Preoperative imaging of the lung sentinel lymphatic basin with computed tomographic lymphography: a preliminary study. Ann Thorac Surg 2004;77:1033–8Google Scholar
15Suga, K, Karino, Y, Fujita, T, Okada, M, Kawakami, Y, Ueda, K et al. Cutaneous drainage lymphatic map with interstitial multidetector-row computed tomographic lymphography using iopamidol: preliminary results. Lymphology 2007;40:6373Google Scholar
16Wu, H, Xu, X, Ying, H, Hoffman, MR, Shen, N, Sha, Y et al. Preliminary study of indirect CT lymphography-guided sentinel lymph node biopsy in a tongue VX2 carcinoma model. Int J Oral Maxillofac Surg 2009;38:1268–72CrossRefGoogle Scholar
17Wu, H, Ying, H, Xi, X, Shen, N, Shu, Y, Hoffman, MR et al. Localization of the sentinel lymph node in tongue VX2 carcinoma via indirect CT lymphography combined with methylene blue dye injection. Acta Otolaryngol (Stockh) 130(4):503–10CrossRefGoogle Scholar
18Ying, H, Wu, H, Zhou, L. Establishment of the deep cervical lymph node metastasis model of tongue VX2 carcinoma and observation of its metastatic features. Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2008;43:778–81Google ScholarPubMed
19Fischbein, NJ, Noworolski, SM, Henry, RG, Kaplan, MJ, Dillon, WP, Nelson, SJ. Assessment of metastatic cervical adenopathy using dynamic contrast-enhanced MR imaging. Am J Neuroradiol 2003;24:301–11Google ScholarPubMed
20Herborn, CU, Lauenstein, TC, Vogt, FM, Lauffer, RB, Debatin, JF, Ruehm, SG. Interstitial MR lymphography with MS-325: characterization of normal and tumor-invaded lymph nodes in a rabbit model. Am J Roentgenol 2002;179:1567–72Google Scholar
21Jefferis, AF, Berenbaum, MC. The rabbit Vx2 tumor as a model for carcinomas of the tongue and larynx. Acta Otolaryngol (Stockh) 1989;108:152–60Google Scholar
22Seki, S, Fujimura, A. Three dimensional changes in lymphatic architecture around VX2 tongue cancer – dynamic changes after administration of antiangiogenic agent. Lymphology 2003;36:199208Google Scholar
23Seki, S, Fujimura, A. Three-dimensional changes in lymphatic architecture around VX2 tongue cancer – dynamics of growth of cancer. Lymphology 2003;36:128–39Google Scholar
24Hamaguchi, S, Tohnai, I, Ito, A, Mitsudo, K, Shigetomi, T, Ito, M et al. Selective hyperthermia using magnetoliposomes to target cervical lymph node metastasis in a rabbit tongue tumor model. Cancer Sci 2003;94:834–9Google Scholar
25Gourin, CG, Conger, BT, Porubsky, ES, Sheils, WC, Bilodeau, PA, Coleman, TA. The effect of occult nodal metastases on survival and regional control in patients with head and neck squamous cell carcinoma. Laryngoscope 2008;118:1191–4Google Scholar
26Mack, MG, Rieger, J, Baghi, M, Bisdas, S, Vogl, TJ. Cervical lymph nodes. Eur J Radiol 2008;66:493500Google Scholar
27Wolf, GL, Gazelle, GS, McIntire, G, Bacon, E, Toner, J, Cooper, E. Percutaneous computed tomographic lymphography of normal, inflamed, and cancerous nodes in the rabbit. Invest Radiol 1994;29(Supplement 2):S30–2Google Scholar
28Tangoku, A, Seike, J, Nakano, K, Nagao, T, Honda, J, Yoshida, T et al. Current status of sentinel lymph node navigation surgery in breast and gastrointestinal tract. J Med Invest 2007;54:118Google Scholar
29Stephenson, NJ, Sandeman, TF, McKenzie, AF. Has lymphography a role in early stage testicular germ cell tumours? Australas Radiol 1995;39:54–7Google Scholar
30Voneschenbach, AC, Jing, BS, Wallace, S. Lymphangiography in genitourinary cancer. Urol Clin North Am 1985;12:715–23Google Scholar
31Lang, JH. Lymphangiography in ovarian cancer [in Chinese]. Zhonghua Fu Chan Ke Za Zhi 1989;24:2931, 58Google Scholar