title: CT-guided hookwire placement: a technical innovation for preoperative localization of nonpalpable cervical lymph nodes.
abstract: The aim is to describe the technique of preoperative CT-guided hookwire localization of small, but suspicious, cervical lymph nodes. We present 3 patients who underwent the procedure for nonpalpable cervical nodes detected on PET/CT prior to complete surgical resection of the nodes. The details of the radiological procedure, surgical outcomes, and pathologic results are described. The mean intervention time for preoperative hookwire localization was 9 minutes (range 7-14 minutes). There were no complications. All surgeons felt that the lengths of the surgical skin incision and operative times were reduced because of localization. The pathologic diagnoses were 2 benign nodes and 1 case of metastatic ovarian carcinoma. In conclusion, preoperative CT-guided hookwire localization is a useful technique for guiding surgical excision, especially when cervical nodes are small and deep in location.
authors.affiliation: Department of Radiology, Duke University Medical Center, Box 3808, Erwin Rd, Durham NC, 27710, USA. jennykh@gmail.com
authors.forename: J K
authors.initials: JK
authors.lastname: Hoang
authors.forename: R
authors.initials: R
authors.lastname: De Jesus
authors.forename: J D
authors.initials: JD
authors.lastname: Eastwood
authors.forename: A R
authors.initials: AR
authors.lastname: Gafton
authors.forename: D L
authors.initials: DL
authors.lastname: Witsell
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery; D005260:Female; D057918:Fiducial Markers; D006801:Humans; D008197:Lymph Node Excision / Q000295:instrumentation*; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D009339:Needles; D011300:Preoperative Care; D019919:Prosthesis Implantation / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods*