title: Lymphosonographic sentinel node biopsy of the supraglottis in a swine model.
abstract: OBJECTIVE
  To test the feasibility of a novel contrast-enhanced ultrasound (CEUS) technique, or lymphosonography, for sentinel node biopsy (SNB) of the supraglottis in a porcine model.
  
  
  METHODS
  In this prospective, nonrandomized animal study, blue dye and ultrasound contrast agent were injected into the supraglottis in seven 50-kg Yorkshire swine. Transcutaneous CEUS was used to identify real-time lymphatic flow of contrast through lymph channels (LC) to the sentinel lymph node (SLN). SNB was carried out, visually identifying a blue node, with the assistance of intraoperative CEUS. Bilateral modified radical neck dissections were performed to search for any residual contrast-positive or blue SLNs.
  
  
  RESULTS
  In each case, at least one SLN was identified by preoperative CEUS. A total of 12 nodes were identified on preoperative CEUS, and 11 of 12 nodes were stained with blue dye (91.7%). No residual blue or contrast-positive nodes were identified on neck dissection.
  
  
  CONCLUSIONS
  Lymphosonographic SNB of the supraglottis in a porcine model is technically feasible, and yields results comparable to traditional blue dye-guided techniques. No "shine-through" effect or nonsequential nodal enhancement occurred. This technique holds promise for sentinel node biopsy and allows a novel method for in vivo investigation of the lymphatic system.
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: Christopher R
authors.initials: CR
authors.lastname: Grindle
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Merton
authors.forename: Barry B
authors.initials: BB
authors.lastname: Goldberg
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 / Q000008:administration & dosage; D005240:Feasibility Studies; D006258:Head and Neck Neoplasms / Q000473:pathology; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008751:Methylene Blue / Q000008:administration & dosage; D023421:Models, Animal; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013552:Swine; D018615:Ultrasonography, Doppler, Color
chemical_list: D003287:Contrast Media; D008751:Methylene Blue