title: Contrast enhanced ultrasound of sentinel lymph nodes.
abstract: Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient's prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal "avascular" areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue(®), Sonazoid(®) and Definity(®). This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.
authors.affiliation: Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany.
authors.forename: XinWu
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany.
authors.forename: Andre
authors.initials: A
authors.lastname: Ignee
authors.affiliation: Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Michael Bachmann
authors.initials: MB
authors.lastname: Nielsen
authors.affiliation: Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Schreiber-Dietrich
authors.affiliation: Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany.
authors.forename: Chiara
authors.initials: C
authors.lastname: De Molo
authors.affiliation: Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany.
authors.forename: Clara
authors.initials: C
authors.lastname: Pirri
authors.affiliation: Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany.
authors.forename: Maciej
authors.initials: M
authors.lastname: Jedrzejczyk
authors.affiliation: Department of Internal Medicine 2, Caritas-Krankenhaus Bad Mergentheim, Academic Teaching Hospital of the University of Würzburg, Bad Mergentheim, Germany.
authors.forename: Dietrich F
authors.initials: DF
authors.lastname: Christoph
keywords: breast cancer; contrast enhanced ultrasound; melanoma; microbubble contrast agents; preoperative staging; sentinel lymph node