title: Early gastric cancer: feasibility of CT lymphography with ethiodized oil for sentinel node mapping.
abstract: OBJECTIVE
  To evaluate the feasibility of CT lymphography with ethiodized oil for sentinel node mapping in porcine stomachs and in patients with early gastric cancer.
  
  
  METHODS
  Approval for the animal study was obtained from the authors' institutional animal use and care administrative advisory committee, the clinical study was approved by the institutional review board, and informed consent was obtained from each participant. Five pigs underwent CT lymphography 1 hour after gastric subserosal injection of 1 mL ethiodized oil and sentinel node mapping with injection of 1 mL methylene blue. Ethiodized oil retention nodes were identified on the radiographic images of the gastric specimen and removed for histopathologic examination. In addition, 10 patients with early gastric cancer underwent CT lymphography with peritumoral injection of 1 mL ethiodized oil, followed by sentinel basin extirpation with CT and routine nodal dissection. The removed sentinel basins were examined by radiography. Histopathologic examination was performed for dissected nodes, including sentinel nodes.
  
  
  RESULTS
  In each of the five pigs, CT showed one perigastric ethiodized oil retention node. After harvesting the ethiodized oil retention node, blue-stained areas were identified in the five removed nodes and intranodal ethiodized oil was detected on histopathologic examination. In all 10 patients, CT lymphography with ethiodized oil successfully defined the sentinel basin with ethiodized oil retention nodes. CT lymphography revealed 20 ethiodized oil retention nodes. After basin extirpation, 28 and 46 nodes were detected on radiographic and histopathologic examinations. Histopathologic examination revealed that one patient had micrometastases at two sentinel nodes and another patient had isolated tumor cells at one sentinel node. No patient had metastasis in nonsentinel nodes.
  
  
  CONCLUSIONS
  CT lymphography with ethiodized oil may be a feasible method for sentinel node mapping in patients with early gastric cancer.
authors: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.
authors: Young Hoon
authors: YH
authors: Kim
authors: Yoon Jin
authors: YJ
authors: Lee
authors: Ji Hoon
authors: JH
authors: Park
authors: Kyoung Ho
authors: KH
authors: Lee
authors: Hye Seung
authors: HS
authors: Lee
authors: Young Soo
authors: YS
authors: Park
authors: Do Joong
authors: DJ
authors: Park
authors: Hyung-Ho
authors: HH
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008207:Lymphatic Metastasis; D008220:Lymphography / Q000379:methods*; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage; D008875:Middle Aged; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D013552:Swine; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D004998:Ethiodized Oil; D008751:Methylene Blue