title: Ultrasound-guided contrast-enhanced sentinel node biopsy of the head and neck in a porcine model.
abstract: OBJECTIVE
  To test the feasibility of contrast-enhanced ultrasound (CEUS)-guided sentinel lymph node biopsy (SNB) of the head and neck in a porcine model.
  
  
  METHODS
  In this prospective, nonrandomized study, methylene blue and Sonazoid were injected into the lateral tongue or floor of mouth (FOM) of four swine. Real-time CEUS was used to identify contrast in the lymphatic channels flowing to the sentinel lymph node (SLN). Endoscopic or open SNB was performed. Neck dissection was then performed, and the residual nodal packet was examined for remaining contrast-enhancing or blue dye-stained nodes.
  
  
  RESULTS
  In all eight procedures, the SLN was visualized with ultrasound and blue dye. Seven procedures identified a single SLN, and one identified two SLNs. Subsequent neck dissections revealed no other nodes containing methylene blue or contrast in the nodal specimen or operative bed.
  
  
  CONCLUSIONS
  CEUS-guided SNB of the head and neck in swine is feasible, with success comparable to blue dye-guided SNB. This technique may offer several advantages over traditional techniques, and warrants further study.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA. joseph.curry@jefferson.edu
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Curry
authors.forename: Esa
authors.initials: E
authors.lastname: Bloedon
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Malloy
authors.forename: David M
authors.initials: DM
authors.lastname: Cognetti
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Merton
authors.forename: Barry B
authors.initials: BB
authors.lastname: Goldberg
authors.forename: William M
authors.initials: WM
authors.lastname: Keane
authors.forename: David
authors.initials: D
authors.lastname: Rosen
authors.forename: Edmund A
authors.initials: EA
authors.lastname: Pribitkin
mesh_terms: D000818:Animals; D003287:Contrast Media; D004195:Disease Models, Animal; D005240:Feasibility Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D037981:Neck Dissection; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013552:Swine; D014463:Ultrasonography
chemical_list: D003287:Contrast Media