Superparamagnetic iron oxide-enhanced interstitial magnetic resonance lymphography to detect a sentinel lymph node in tongue cancer patients

Abstract

Conclusion: This is the first report on human sentinel node (SN) detection by interstitial magnetic resonance (MR) lymphography with superparamagnetic iron oxide (SPIO) in tongue cancer patients who also underwent lymphoscintigraphy. Our results indicate that further studies are warranted, as this novel method may replace current scintigraphic techniques. Objectives: To examine the feasibility of interstitial MR lymphography using SPIO for SN detection in the head and neck region. Methods: MR images were acquired sequentially at 10 min, 30 min, and 24 h after submucosally injecting 0.1 ml SPIO (ferucarbotran) around the tumor in three patients with tongue cancer without cervical lymph node metastasis (clinical T2N0M0). Results: The SNs were clearly visualized in the 10 min interstitial MR lymphography images and were completely concordant with those visualized by ^99mTc-radiocolloid lymphoscintigraphy and a gamma probe in all cases. Iron incorporation into the SNs was confirmed by pathological examination.

Keywords::

• Sentinel node navigation surgery
• head and neck cancer
• lymphoscintigraphy

Acknowledgments

The authors acknowledge the contribution of Osamu Matsubara, MD, PhD and Kosuke Miyai, MD, for their technical assistance during staining and their valuable comments for histology discussed in this manuscript. This research was supported by Health and Labor Sciences Research Grant for Clinical Cancer Research (H21-Gannrinshou-Ippan-016) from the Ministry of Health, Labor and Welfare, Japan. A summary of this manuscript was presented at Collegium Oto-Rhino-Laryngologicum Amicitiae Sacrum in August 29, 2012 in Rome, Italy.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.