Dynamic MR lymphangiography and carbon dye for sentinel lymph node detection: a solution for sentinel lymph node biopsy in mucosal head and neck cancer.
BACKGROUND
The practical application of sentinel lymph node biopsy in squamous cell carcinoma of the head and neck is restricted by the time sensitivity of blue dye and lack of spatial resolution and nonspecific node enhancement with radiocolloid. This study evaluates the use of magnetic resonance (MR) lymphangiography and carbon dye labeling to circumvent these limitations.


METHODS
Gadomer/carbon dye mixture was injected into the tongue and stifle of adult swine (n = 4). MR lymphatic mapping was followed by intraoperative mapping with isosulfan blue dye. Sentinel lymph node biopsy and completion node dissection were performed 60 minutes after injection in four nodal basins and at 7 days after injection in eight.


RESULTS
The technique was successful in all 12 nodal basins. The sentinel lymph nodes were stained black at the time of the immediate and delayed dissections.


CONCLUSIONS
MR lymphangiography provides temporal and anatomic localization of the sentinel lymph node with a single investigation. Carbon dye is a sensitive and persistent visual marker of MRI-targeted sentinel lymph nodes.
Nason
Richard W
RW
Department of Surgery, University of Manitoba, GF433 820 Sherbrook Street, Health Sciences Center, Winnipeg, Manitoba, Canada R3A1R9.
Torchia
Mark G
MG
Morales
Carmen M
CM
Thliveris
James
J
D000818:Animals; D002244:Carbon; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D004396:Coloring Agents; D005682:Gadolinium; D006258:Head and Neck Neoplasms / Q000473:pathology*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013264:Stifle / Q000473:pathology; D013552:Swine; D013997:Time Factors; D014059:Tongue / Q000473:pathology
D004396:Coloring Agents; D012394:Rosaniline Dyes; C028433:chinese ink; C402765:gadomer 17; C025484:iso-sulfan blue; D002244:Carbon; D005682:Gadolinium