title: Visualization of lymphatic basin from the tumor using magnetic resonance lymphography with superparamagnetic iron oxide in patients with thoracic esophageal cancer.
abstract: 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.
authors.affiliation: Department of Radiology, Akita University School of Medicine, Akita, Japan. kishiyam@doc.med.akita-u.ac.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Ishiyama
authors.forename: Satoru
authors.initials: S
authors.lastname: Motoyama
authors.forename: Noriaki
authors.initials: N
authors.lastname: Tomura
authors.forename: Ryuji
authors.initials: R
authors.lastname: Sashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imano
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Ogawa
authors.forename: Komei
authors.initials: K
authors.lastname: Narita
authors.forename: Jiro
authors.initials: J
authors.lastname: Watarai
mesh_terms: 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
chemical_list: D003287:Contrast Media; D003911:Dextrans; D058185:Magnetite Nanoparticles; D010087:Oxides; D007501:Iron; C065507:ferumoxides; D052203:Ferrosoferric Oxide