title: Preoperative imaging of sentinel lymph nodes in gastric cancer using CT lymphography.
abstract: OBJECTIVE
  Preoperative identification of the sentinel lymph node (SLN) in gastric cancer (GC) patients may have great advantages for the minimally invasive treatment. This study was performed to evaluate the possibility of preoperative SLN detection using CT lymphography.
  
  
  METHODS
  Fourteen patients with early GC were enrolled. CT images were obtained before and at 1, 3, and 5 minutes after endoscopic submucosal peritumoral injection of 2 mL iopamidol. For patients with clearly identified SLNs, to make comparisons with the CT lymphography results, intraoperative SLN detection was performed using subserosally injected Indocyanine green (ICG) lymphography and ex vivo ICG and iopamidol lymphography using mammography was also performed.
  
  
  RESULTS
  CT lymphography clearly visualized draining lymphatics and SLNs in 4 (28.6%) out of 14 patients. All clearly visualized SLNs (one to three SLNs per patient) under preoperative imaging were detected in the same location by intraoperative ICG lymphography and ex vivo ICG and iopamidol lymphography using mammography. All preoperative SLN detections were observed with the primary tumors in the lower third of the stomach.
  
  
  CONCLUSIONS
  Although our study demonstrated a SLN detection rate of less than 30%, CT lymphography with radio-contrast showed potential as a method of preoperative SLN detection for GC.
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
authors.forename: Yong Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Lim
authors.forename: Myeong-Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
authors.forename: Ki Whang
authors.initials: KW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007479:Iopamidol; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008220:Lymphography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011300:Preoperative Care; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D007479:Iopamidol