Contrast-Enhanced Sonography for Detection of Secondary Lymph Nodes in a Melanoma Tumor Animal Model
Identifieur interne : 002C11 ( Main/Exploration ); précédent : 002C10; suivant : 002C12Contrast-Enhanced Sonography for Detection of Secondary Lymph Nodes in a Melanoma Tumor Animal Model
Auteurs : Ji-Bin Liu ; Daniel A. Merton ; Adam C. Berger ; Flemming Forsberg ; Agnieszka Witkiewicz ; Hongjia Zhao ; John R. Eisenbrey ; Traci B. Fox ; Barry B. GoldbergSource :
- Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine [ 0278-4297 ] ; 2014.
Abstract
To investigate the use of contrast-enhanced ultrasound imaging (US) for detection of secondary lymph nodes (LNs) in a naturally occurring melanoma swine model compared to surgery and pathologic assessment.
Twenty-seven Sinclair swine were studied. The perfluorobutane microbubble contrast agent Sonazoid (GE Healthcare, Oslo, Norway) was administered (1.0 mL total dose) around the melanoma, and contrast-enhanced US was used to localize contrast-enhanced sentinel lymph nodes (SLNs). Then Sonazoid (dose, 0.25–1.0 mL) was injected into the SLNs to detect contrast-enhanced efferent lymphatic channels and secondary LNs. After peritumoral injection of blue dye, a surgeon (blinded to the contrast-enhanced US results) performed a radical LN dissection. Contrast-enhanced US was used to guide removal of any enhanced secondary LNs left after radical LN dissection. Clustered conditional logistic regression analyzed the benefit of contrast-enhanced US–directed secondary LN dissection over radical LN dissection using pathologic findings as the reference standard.
A total of 268 secondary LNs were resected, with 59 (22%) containing metastases. Contrast-enhanced US detected 92 secondary LNs; 248 were identified by radical LN dissection; and 68 were identified by both methods. Metastases were detected in 20% (51 of 248) and 40% (37 of 92) of the secondary LNs identified by radical LN dissection and contrast-enhanced US, respectively. Thus, secondary LNs detected by contrast-enhanced US were nearly 5 times more likely to contain metastases than secondary LNs removed by radical LN dissection (odds ratio, 4.8;
Secondary LNs can be detected by using contrast-enhanced US after injection of Sonazoid into SLNs. Secondary LNs detected with contrast-enhanced US are significantly more likely to contain metastases than those removed by radical LN dissection.
Url:
DOI: 10.7863/ultra.33.6.939
PubMed: 24866601
PubMed Central: 4404634
Affiliations:
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Berger</name></author><author><name sortKey="Forsberg, Flemming" sort="Forsberg, Flemming" uniqKey="Forsberg F" first="Flemming" last="Forsberg">Flemming Forsberg</name></author><author><name sortKey="Witkiewicz, Agnieszka" sort="Witkiewicz, Agnieszka" uniqKey="Witkiewicz A" first="Agnieszka" last="Witkiewicz">Agnieszka Witkiewicz</name></author><author><name sortKey="Zhao, Hongjia" sort="Zhao, Hongjia" uniqKey="Zhao H" first="Hongjia" last="Zhao">Hongjia Zhao</name></author><author><name sortKey="Eisenbrey, John R" sort="Eisenbrey, John R" uniqKey="Eisenbrey J" first="John R." last="Eisenbrey">John R. Eisenbrey</name></author><author><name sortKey="Fox, Traci B" sort="Fox, Traci B" uniqKey="Fox T" first="Traci B." last="Fox">Traci B. Fox</name></author><author><name sortKey="Goldberg, Barry B" sort="Goldberg, Barry B" uniqKey="Goldberg B" first="Barry B." last="Goldberg">Barry B. Goldberg</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24866601</idno><idno type="pmc">4404634</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404634</idno><idno type="RBID">PMC:4404634</idno><idno type="doi">10.7863/ultra.33.6.939</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">003776</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003776</idno><idno type="wicri:Area/Pmc/Curation">003775</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">003775</idno><idno type="wicri:Area/Pmc/Checkpoint">001C53</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001C53</idno><idno type="wicri:Area/Ncbi/Merge">006693</idno><idno type="wicri:Area/Ncbi/Curation">006693</idno><idno type="wicri:Area/Ncbi/Checkpoint">006693</idno><idno type="wicri:doubleKey">0278-4297:2014:Liu J:contrast:enhanced:sonography</idno><idno type="wicri:Area/Main/Merge">002C15</idno><idno type="wicri:Area/Main/Curation">002C11</idno><idno type="wicri:Area/Main/Exploration">002C11</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Contrast-Enhanced Sonography for Detection of Secondary Lymph Nodes in a Melanoma Tumor Animal Model</title><author><name sortKey="Liu, Ji Bin" sort="Liu, Ji Bin" uniqKey="Liu J" first="Ji-Bin" last="Liu">Ji-Bin Liu</name></author><author><name sortKey="Merton, Daniel A" sort="Merton, Daniel A" uniqKey="Merton D" first="Daniel A." last="Merton">Daniel A. Merton</name></author><author><name sortKey="Berger, Adam C" sort="Berger, Adam C" uniqKey="Berger A" first="Adam C." last="Berger">Adam C. Berger</name></author><author><name sortKey="Forsberg, Flemming" sort="Forsberg, Flemming" uniqKey="Forsberg F" first="Flemming" last="Forsberg">Flemming Forsberg</name></author><author><name sortKey="Witkiewicz, Agnieszka" sort="Witkiewicz, Agnieszka" uniqKey="Witkiewicz A" first="Agnieszka" last="Witkiewicz">Agnieszka Witkiewicz</name></author><author><name sortKey="Zhao, Hongjia" sort="Zhao, Hongjia" uniqKey="Zhao H" first="Hongjia" last="Zhao">Hongjia Zhao</name></author><author><name sortKey="Eisenbrey, John R" sort="Eisenbrey, John R" uniqKey="Eisenbrey J" first="John R." last="Eisenbrey">John R. Eisenbrey</name></author><author><name sortKey="Fox, Traci B" sort="Fox, Traci B" uniqKey="Fox T" first="Traci B." last="Fox">Traci B. Fox</name></author><author><name sortKey="Goldberg, Barry B" sort="Goldberg, Barry B" uniqKey="Goldberg B" first="Barry B." last="Goldberg">Barry B. Goldberg</name></author></analytic><series><title level="j">Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine</title><idno type="ISSN">0278-4297</idno><idno type="eISSN">1550-9613</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objectives</title><p id="P1">To investigate the use of contrast-enhanced ultrasound imaging (US) for detection of secondary lymph nodes (LNs) in a naturally occurring melanoma swine model compared to surgery and pathologic assessment.</p></sec><sec id="S2"><title>Methods</title><p id="P2">Twenty-seven Sinclair swine were studied. The perfluorobutane microbubble contrast agent Sonazoid (GE Healthcare, Oslo, Norway) was administered (1.0 mL total dose) around the melanoma, and contrast-enhanced US was used to localize contrast-enhanced sentinel lymph nodes (SLNs). Then Sonazoid (dose, 0.25–1.0 mL) was injected into the SLNs to detect contrast-enhanced efferent lymphatic channels and secondary LNs. After peritumoral injection of blue dye, a surgeon (blinded to the contrast-enhanced US results) performed a radical LN dissection. Contrast-enhanced US was used to guide removal of any enhanced secondary LNs left after radical LN dissection. Clustered conditional logistic regression analyzed the benefit of contrast-enhanced US–directed secondary LN dissection over radical LN dissection using pathologic findings as the reference standard.</p></sec><sec id="S3"><title>Results</title><p id="P3">A total of 268 secondary LNs were resected, with 59 (22%) containing metastases. Contrast-enhanced US detected 92 secondary LNs; 248 were identified by radical LN dissection; and 68 were identified by both methods. Metastases were detected in 20% (51 of 248) and 40% (37 of 92) of the secondary LNs identified by radical LN dissection and contrast-enhanced US, respectively. Thus, secondary LNs detected by contrast-enhanced US were nearly 5 times more likely to contain metastases than secondary LNs removed by radical LN dissection (odds ratio, 4.8; <italic>P</italic> < .0001). Twenty-two of the 180 secondary LNs (12%) identified only by radical LN dissection contained metastases, whereas contrast-enhanced US identified 20 secondary LNs after the surgeon completed the radical LN dissection, of which 8 (40%) contained metastases.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Secondary LNs can be detected by using contrast-enhanced US after injection of Sonazoid into SLNs. Secondary LNs detected with contrast-enhanced US are significantly more likely to contain metastases than those removed by radical LN dissection.</p></sec></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Berger, Adam C" sort="Berger, Adam C" uniqKey="Berger A" first="Adam C." last="Berger">Adam C. Berger</name><name sortKey="Eisenbrey, John R" sort="Eisenbrey, John R" uniqKey="Eisenbrey J" first="John R." last="Eisenbrey">John R. Eisenbrey</name><name sortKey="Forsberg, Flemming" sort="Forsberg, Flemming" uniqKey="Forsberg F" first="Flemming" last="Forsberg">Flemming Forsberg</name><name sortKey="Fox, Traci B" sort="Fox, Traci B" uniqKey="Fox T" first="Traci B." last="Fox">Traci B. Fox</name><name sortKey="Goldberg, Barry B" sort="Goldberg, Barry B" uniqKey="Goldberg B" first="Barry B." last="Goldberg">Barry B. Goldberg</name><name sortKey="Liu, Ji Bin" sort="Liu, Ji Bin" uniqKey="Liu J" first="Ji-Bin" last="Liu">Ji-Bin Liu</name><name sortKey="Merton, Daniel A" sort="Merton, Daniel A" uniqKey="Merton D" first="Daniel A." last="Merton">Daniel A. Merton</name><name sortKey="Witkiewicz, Agnieszka" sort="Witkiewicz, Agnieszka" uniqKey="Witkiewicz A" first="Agnieszka" last="Witkiewicz">Agnieszka Witkiewicz</name><name sortKey="Zhao, Hongjia" sort="Zhao, Hongjia" uniqKey="Zhao H" first="Hongjia" last="Zhao">Hongjia Zhao</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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