The Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
The Flint Animal Cancer Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Vet Comp Oncol. 2020 Dec;18(4):634-644. doi: 10.1111/vco.12585. Epub 2020 Mar 25.
Identification of metastatic disease critically impacts the care and prognosis of patients with neoplasia. Multiple techniques exist for identifying the sentinel or first lymph node(s) that receive draining tumour lymph. Identification of the sentinel lymph node enables accurate tissue sampling for determination of lymphatic metastasis. The aims of this study were to develop a computed tomography (CT) protocol for identifying the sentinel lymph node in dogs with tumours of the head and neck. In addition, indirect CT lymphography was compared to lymphoscintigraphy and vital dye injection to determine which technique more reliably identified the sentinel lymph node. CT indirect lymphography using intratumoral injection of iodinated contrast identified draining lymphatic vessels in eight of 18 dogs and identified the sentinel lymph node in five of 18 dogs. CT indirect lymphography employing four-quadrant peritumoral injection of iodinated contrast identified draining lymphatic vessels in 18 of 20 dogs and identified the sentinel lymph node in 11 of 20 dogs. Vital dye injection and lymphoscintigraphy identified the sentinel lymph node in 17 of 18 and 20 of 20 dogs, respectively. Identified sentinel lymph nodes were either ipsilateral or bilateral to the primary tumour. Both CT techniques were found to be safe and simple. Peritumoral injection has the greatest promise for the detection of sentinel lymph nodes in various head and neck cancers using CT, while lymphoscintigraphy had the greatest success of the compared techniques.
转移疾病的识别对肿瘤患者的治疗和预后具有重要影响。目前有多种技术可用于识别接收引流肿瘤淋巴的前哨或第一个淋巴结。前哨淋巴结的识别可实现对淋巴转移进行准确的组织取样。本研究旨在为头颈部肿瘤犬制定一种用于识别前哨淋巴结的 CT 方案。此外，还比较了间接 CT 淋巴造影与淋巴闪烁成像和活染料注射，以确定哪种技术更可靠地识别前哨淋巴结。经肿瘤内注射碘对比剂的 CT 间接淋巴造影可在 18 只犬中的 8 只中识别引流淋巴管，并在 18 只犬中的 5 只中识别前哨淋巴结。采用四象限肿瘤周围注射碘对比剂的 CT 间接淋巴造影可在 20 只犬中的 18 只中识别引流淋巴管，并在 20 只犬中的 11 只中识别前哨淋巴结。活染料注射和淋巴闪烁成像分别在 18 只犬中的 17 只和 20 只犬中的 20 只中识别了前哨淋巴结。识别出的前哨淋巴结与原发性肿瘤同侧或双侧。这两种 CT 技术都被发现是安全且简单的。与其他技术相比，肿瘤周围注射在使用 CT 检测各种头颈部癌症的前哨淋巴结方面具有最大的应用前景，而淋巴闪烁成像在已比较的技术中具有最大的成功率。
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