Skip to main content
Erschienen in: Breast Cancer 2/2014

01.03.2014 | Original Article

Computed tomographic lymphography predicts the difficulty of sentinel lymph node biopsy with dye

verfasst von: Kazunori Yokohata, Masami Hattori, Takaaki Fujimoto, Nobuhito Chikazawa, Ryo Maeyama, Naoki Yamanaka, Hideo Kuroki, Nobuhiko Sasaki, Nobuhisa Kameoka, Naoyuki Matoba

Erschienen in: Breast Cancer | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Sentinel lymph node biopsy (SLNB) has been a method of choice for treating breast cancer. Computed tomographic lymphography (CT-LG) provides a view of the sentinel lymph node (SLN) with the detailed lymphatic anatomy preoperatively, and the SLN is easily identified during SLNB. In this article, we examined the usefulness of CT-LG to predict the difficulty of SLNB with the dye method.

Methods

A total of 41 consecutive patients who underwent CT-LG were enrolled in this study. Each CT-LG image was reviewed by one of our co-authors. The images of lymph vessels (LVs) and SLNs were assorted into three categories: not visualized, poorly visualized, and well visualized. The time engaged in SLNB with the dye method was recorded in 30 patients.

Results

The time engaged in SLNB between two groups was compared: patients in whom both the SLN and LVs were well visualized (n = 16) and the remaining patients (n = 14). The former required a significantly shorter time than the latter (12.6 ± 4.1 vs. 17.6 ± 6.7 min, respectively; p = 0.025 by Mann-Whitney U test).

Conclusions

Our study clearly demonstrates that the CT-LG findings of well-visualized LVs and SLNs predict the easy access to the stained LVs and SLNs. This information provides several advantages, including the fact that an easy SLNB case can be selected for a doctor with little experience in SLNB, and the volume of dye and/or length of massage can be changed for better identification of stained LVs and SLNs during SLNB.
Literatur
1.
Zurück zum Zitat Morton DE, Wen D, Cochran A. Management of early-stage melanoma by intraoperative lymphatic mapping and selective lymphadenectomy: an alternative to routine elective lymphadenectomy or “watch and wait”. Surg Oncol Clin North Am. 1992;1:247–59. Morton DE, Wen D, Cochran A. Management of early-stage melanoma by intraoperative lymphatic mapping and selective lymphadenectomy: an alternative to routine elective lymphadenectomy or “watch and wait”. Surg Oncol Clin North Am. 1992;1:247–59.
2.
Zurück zum Zitat Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–401.PubMedCrossRef Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer. Ann Surg. 1994;220:391–401.PubMedCrossRef
3.
Zurück zum Zitat Van der Veen H, Hoekstra OS, Paul MA, Cuesta MA, Meijer S. Gamma-probe-guided sentinel node biopsy to select patients with melanoma for lymphadenectomy. Br J Surg. 1994;81:1769–70.PubMedCrossRef Van der Veen H, Hoekstra OS, Paul MA, Cuesta MA, Meijer S. Gamma-probe-guided sentinel node biopsy to select patients with melanoma for lymphadenectomy. Br J Surg. 1994;81:1769–70.PubMedCrossRef
4.
Zurück zum Zitat Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bendoni M, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet. 1997;349:1864–7.PubMedCrossRef Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bendoni M, et al. Sentinel-node biopsy to avoid axillary dissection in breast cancer with clinically negative lymph-nodes. Lancet. 1997;349:1864–7.PubMedCrossRef
5.
Zurück zum Zitat Suga K, Yuan Y, Okada M, Matsunaga N, Yamamoto S, Oka M. Breast sentinel lymph node mapping at CT lymphography with iopamidol: preliminary experience. Radiology. 2004;230:543–52.PubMedCrossRef Suga K, Yuan Y, Okada M, Matsunaga N, Yamamoto S, Oka M. Breast sentinel lymph node mapping at CT lymphography with iopamidol: preliminary experience. Radiology. 2004;230:543–52.PubMedCrossRef
6.
Zurück zum Zitat Tangoku A, Yamamoto S, Suga K, Ueda K, Nagashima Y, Hida M, et al. Sentinel lymph node biopsy using computed tomography-lymphography in patients with breast cancer. Surgery. 2004;135:258–65.PubMedCrossRef Tangoku A, Yamamoto S, Suga K, Ueda K, Nagashima Y, Hida M, et al. Sentinel lymph node biopsy using computed tomography-lymphography in patients with breast cancer. Surgery. 2004;135:258–65.PubMedCrossRef
7.
Zurück zum Zitat Minohata J, Takao S, Hirokaga K. Sentinel lymph node biopsy using CT lymphography in breast cancer. Breast Cancer. 2011;18:129–36.PubMedCrossRef Minohata J, Takao S, Hirokaga K. Sentinel lymph node biopsy using CT lymphography in breast cancer. Breast Cancer. 2011;18:129–36.PubMedCrossRef
8.
Zurück zum Zitat Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12:211–5.PubMedCrossRef Kitai T, Inomoto T, Miwa M, Shikayama T. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer. Breast Cancer. 2005;12:211–5.PubMedCrossRef
9.
Zurück zum Zitat Tagaya N, Yamazaki R, Nakagawa A, Abe A, Hamada K, Kubota K, et al. Intraoperative identification of sentinel lymph nodes by near-infrared fluorescence imaging in patients with breast cancer. Am J Surg. 2008;195:850–3.PubMedCrossRef Tagaya N, Yamazaki R, Nakagawa A, Abe A, Hamada K, Kubota K, et al. Intraoperative identification of sentinel lymph nodes by near-infrared fluorescence imaging in patients with breast cancer. Am J Surg. 2008;195:850–3.PubMedCrossRef
10.
Zurück zum Zitat Minohata J, Tatsumi K, Yoshida A, Ishikawa Y, Wakuya J. Sentinel lymph node biopsy using CT-lymphography with ICG fluorescence navigation in breast cancer. Jpn J Breast Cancer. 2009;24:183–8. Minohata J, Tatsumi K, Yoshida A, Ishikawa Y, Wakuya J. Sentinel lymph node biopsy using CT-lymphography with ICG fluorescence navigation in breast cancer. Jpn J Breast Cancer. 2009;24:183–8.
11.
Zurück zum Zitat Takahashi 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;6:57.PubMedCentralPubMedCrossRef Takahashi 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;6:57.PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Minato M, Hirose C, Sasa M, Nishitani H, Hirose Y, Morimoto T. 3-Dimensional computed tomography lymphography-guided identification of sentinel lymph nodes in breast cancer patients using subcutaneous injection of nonionic contrast medium. J Comput Assist Tomogr. 2004;28:46–51.PubMedCrossRef Minato M, Hirose C, Sasa M, Nishitani H, Hirose Y, Morimoto T. 3-Dimensional computed tomography lymphography-guided identification of sentinel lymph nodes in breast cancer patients using subcutaneous injection of nonionic contrast medium. J Comput Assist Tomogr. 2004;28:46–51.PubMedCrossRef
13.
Zurück zum Zitat Motomura K, Ishitobi M, Komoike Y, Koyama H, Noguchi A, Sumino H, et al. SPIO-enhanced magnetic resonance imaging for the detection of metastases in sentinel nodes localized by computed tomography lymphography in patients with breast cancer. Ann Surg Oncol. 2011;18:3422–9.PubMedCrossRef Motomura K, Ishitobi M, Komoike Y, Koyama H, Noguchi A, Sumino H, et al. SPIO-enhanced magnetic resonance imaging for the detection of metastases in sentinel nodes localized by computed tomography lymphography in patients with breast cancer. Ann Surg Oncol. 2011;18:3422–9.PubMedCrossRef
14.
Zurück zum Zitat Yamamoto S, Maeda N, Tamesa M, Nagashima Y, Yoshimura K, Oka M. Prospective ultrasonographic prediction of sentinel lymph node metastasis by real-time virtual sonography constructed with three-dimensional computed tomography-lymphography in breast cancer patients. Breast Cancer. 2012;19:77–82.PubMedCrossRef Yamamoto S, Maeda N, Tamesa M, Nagashima Y, Yoshimura K, Oka M. Prospective ultrasonographic prediction of sentinel lymph node metastasis by real-time virtual sonography constructed with three-dimensional computed tomography-lymphography in breast cancer patients. Breast Cancer. 2012;19:77–82.PubMedCrossRef
Metadaten
Titel
Computed tomographic lymphography predicts the difficulty of sentinel lymph node biopsy with dye
verfasst von
Kazunori Yokohata
Masami Hattori
Takaaki Fujimoto
Nobuhito Chikazawa
Ryo Maeyama
Naoki Yamanaka
Hideo Kuroki
Nobuhiko Sasaki
Nobuhisa Kameoka
Naoyuki Matoba
Publikationsdatum
01.03.2014
Verlag
Springer Japan
Erschienen in
Breast Cancer / Ausgabe 2/2014
Print ISSN: 1340-6868
Elektronische ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-012-0385-7

Weitere Artikel der Ausgabe 2/2014

Breast Cancer 2/2014 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.