Wakisaka Naohiro, Endo Kazuhira, Kitazawa Tomohiro, Shimode Yuzo, Kato Koroku, Moriyama-Kita Makiko, Koda Wataru, Ikeda Hiroko, Ishikawa Kazuya, Ueno Takayoshi, Nakanishi Yosuke, Kondo Satoru, Sugimoto Hisashi, Yoshimura Kenichi, Tsuji Hiroyuki, Kawashiri Shuichi, Omoto Kiyoka, Yoshizaki Tomokazu
a Department of Otolaryngology, and Head & Neck Surgery , Kanazawa University , Kanazawa , Japan.
b Canon Medical Systems , Ohtawara , Japan.
Acta Otolaryngol. 2019 Jan;139(1):94-99. doi: 10.1080/00016489.2018.1535193. Epub 2019 Jan 24.
In sentinel lymph node (SLN) biopsy for head and neck cancers, the radioisotope method has been the gold standard. However, this method has several problems, such as unavoidable radiation exposure and requirements of expensive equipment.
AIMS/OBJECTIVES: To overcome these problems, we evaluated the contrast-enhanced ultrasonography (CEUS)-guided SLN-detection method, and predicted the SLN metastatic status using novel ultrasound technology, superb microvascular imaging (SMI).
Ten patients (6 with oral and 4 with oropharyngeal cancers) without neck lymph node metastasis were enrolled in this study. Ultrasound contrast agent, Sonazoid, was infiltrated into the mucosa at the primary site to observe the lymphatic ducts and SLNs in the neck field. The detected SLNs were examined for blood flow using SMI to categorize the SLNs metastases-positive or negative.
SLNs were successfully detected in 8 out of 10 cases. In 7 out of the 8 cases, in whom SLNs were successfully detected, the metastatic status of SLNs was correctly diagnosed with SMI.
Although more clinical data are needed based on a larger cohort, establishing the CEUS-guided SLN-detection and criteria for the accurate diagnosis of SLN-metastases using SMI would be valuable as an alternative to radioisotope method, in oral and oropharyngeal cancers.
在头颈部癌前哨淋巴结（SLN）活检中，放射性同位素法一直是金标准。然而，该方法存在一些问题，如不可避免的辐射暴露和对昂贵设备的需求。
为克服这些问题，我们评估了超声造影（CEUS）引导下的SLN检测方法，并使用新型超声技术——超微血管成像（SMI）预测SLN的转移状态。
本研究纳入了10例无颈部淋巴结转移的患者（6例口腔癌患者和4例口咽癌患者）。将超声造影剂声诺维注入原发部位的黏膜，以观察颈部区域的淋巴管和SLN。使用SMI检查检测到的SLN的血流情况，以将SLN分类为转移阳性或阴性。
10例患者中有8例成功检测到SLN。在成功检测到SLN的8例患者中，有7例通过SMI正确诊断了SLN的转移状态。
尽管需要基于更大队列的更多临床数据，但建立CEUS引导下的SLN检测方法以及使用SMI准确诊断SLN转移的标准，作为放射性同位素法的替代方法，在口腔癌和口咽癌中具有重要价值。
