Visualization of lymphatic basin from the tumor using magnetic resonance lymphography with superparamagnetic iron oxide in patients with thoracic esophageal cancer.
OBJECTIVE
To evaluate magnetic resonance (MR) lymphography with submucosal injection of superparamagnetic iron oxide (SPIO) for imaging lymphatic pathways from thoracic esophageal cancer.


METHODS
In 24 patients with esophageal cancer, SPIO was injected into the submucosal layer of the peritumoral region endoscopically and MR lymphography was conducted. In study 1, fast spoiled gradient-recalled acquisition using a steady-state (FSPGR) sequence was performed from the neck to the upper abdomen before and at 20, 40, and 60 minutes after injection in 10 patients. In study 2, FSPGR and spin echo T1-weighted images were obtained after injection in 14 patients. Areas scanned were the neck to the upper mediastinum and the upper abdomen.


RESULTS
In study 1, at 20 minutes after injection, the signal of each lymph node appeared attenuated when compared with precontrast images. The signal-to-noise ratio in lymph nodes exhibiting influx of SPIO was significantly lower than that found on precontrast images (P < 0.0005). In study 2, influx to the neck lymph nodes was detected in 8 patients (64.3%), whereas influx to the upper abdominal lymph nodes was detected in 13 (92.9%).


CONCLUSIONS
Magnetic resonance lymphography with SPIO could visualize the lymphatic pathways draining from the injection site and the location of lymph nodes exhibiting influx of SPIO in patients with thoracic esophageal cancer.
Ishiyama
Koichi
K
Department of Radiology, Akita University School of Medicine, Akita, Japan. kishiyam@doc.med.akita-u.ac.jp
Motoyama
Satoru
S
Tomura
Noriaki
N
Sashi
Ryuji
R
Imano
Hiroshi
H
Ogawa
Jun-ichi
J
Narita
Komei
K
Watarai
Jiro
J
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D003287:Contrast Media; D003911:Dextrans; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D052203:Ferrosoferric Oxide; D006801:Humans; D007267:Injections; D007501:Iron; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D058185:Magnetite Nanoparticles; D008297:Male; D008875:Middle Aged; D010087:Oxides; D019047:Phantoms, Imaging
D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide