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10.3390/jcm13237052
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Article

Sentinel Lymph Node Detection in Early-Stage Oral Squamous Cell Carcinoma Using Magnetic Resonance Lymphography: A Pilot Study

by
Dominique N. V. Donders
1,
Rutger Mahieu
1,
Roosmarijn S. Tellman
1,
Marielle E. P. Philippens
2,
Robert J. J. van Es
1,
Ellen M. Van Cann
1,
Gerben E. Breimer
3,
Remco de Bree
1,* and
Bart de Keizer
4
1
Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
2
Department of Radiotherapy, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
3
Department of Pathology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
4
Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(23), 7052; https://doi.org/10.3390/jcm13237052
Submission received: 15 October 2024 / Revised: 12 November 2024 / Accepted: 19 November 2024 / Published: 22 November 2024
(This article belongs to the Section Oncology)
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Abstract

Objectives: To assess the efficacy of magnetic resonance (MR) lymphography with gadobutrol contrast for sentinel lymph node (SLN) mapping in early-stage oral squamous cell carcinoma (OSCC). Methods: This pilot study compared the identification of SLNs by MR lymphography using a gadolinium-based contrast agent (gadobutrol) to conventional [99mTc]Tc-nanocolloid lymphoscintigraphy (including single-photon emission computed tomography/computed tomography (SPECT/CT)) in 10 early-stage OSCC patients undergoing SLN biopsy. The patients initially underwent conventional lymphoscintigraphy following the peritumoral administration of indocyanine green [99mTc]Tc-nanocolloid (120 megabecquerel; ~0.5 mL). Subsequently, 0.5–1.0 mL gadobutrol was peritumorally injected, and MR imaging was acquired for 30 min. The following day, the identified SLNs were harvested and subjected to a histopathological assessment. The MR lymphography and [99mTc]Tc-nanocolloid lymphoscintigraphy results were evaluated and compared with respect to those of the SLN identification. The reference standard consisted of a histopathological evaluation of the harvested SLNs, complementary neck dissection specimens, and follow-up data. Results: The MR lymphography detected 16 out of 27 SLNs identified by [99mTc]Tc-nanocolloid lymphoscintigraphy, revealing an additional SLN that did not harbor metastasis. MR lymphography failed to identify any SLNs in one patient. Of the seven histopathologically positive SLNs detected by [99mTc]Tc-nanocolloid lymphoscintigraphy, three were identified by MR lymphography. All patients remained disease-free after a median follow-up of 16 months. Compared to [99mTc]Tc-nanocolloid lymphoscintigraphy, MR lymphography using gadobutrol achieved an SLN identification rate of 59%, a sensitivity of 75%, and a negative predictive value of 86%. Conclusions: MR lymphography using gadobutrol demonstrates limited reliability for SLN mapping in early-stage OSCC.
Keywords: mouth neoplasms; sentinel lymph node biopsy; lymphatic metastasis; lymphography; magnetic resonance imaging mouth neoplasms; sentinel lymph node biopsy; lymphatic metastasis; lymphography; magnetic resonance imaging

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MDPI and ACS Style

Donders, D.N.V.; Mahieu, R.; Tellman, R.S.; Philippens, M.E.P.; van Es, R.J.J.; Van Cann, E.M.; Breimer, G.E.; de Bree, R.; de Keizer, B. Sentinel Lymph Node Detection in Early-Stage Oral Squamous Cell Carcinoma Using Magnetic Resonance Lymphography: A Pilot Study. J. Clin. Med. 2024, 13, 7052. https://doi.org/10.3390/jcm13237052

AMA Style

Donders DNV, Mahieu R, Tellman RS, Philippens MEP, van Es RJJ, Van Cann EM, Breimer GE, de Bree R, de Keizer B. Sentinel Lymph Node Detection in Early-Stage Oral Squamous Cell Carcinoma Using Magnetic Resonance Lymphography: A Pilot Study. Journal of Clinical Medicine. 2024; 13(23):7052. https://doi.org/10.3390/jcm13237052

Chicago/Turabian Style

Donders, Dominique N. V., Rutger Mahieu, Roosmarijn S. Tellman, Marielle E. P. Philippens, Robert J. J. van Es, Ellen M. Van Cann, Gerben E. Breimer, Remco de Bree, and Bart de Keizer. 2024. "Sentinel Lymph Node Detection in Early-Stage Oral Squamous Cell Carcinoma Using Magnetic Resonance Lymphography: A Pilot Study" Journal of Clinical Medicine 13, no. 23: 7052. https://doi.org/10.3390/jcm13237052

APA Style

Donders, D. N. V., Mahieu, R., Tellman, R. S., Philippens, M. E. P., van Es, R. J. J., Van Cann, E. M., Breimer, G. E., de Bree, R., & de Keizer, B. (2024). Sentinel Lymph Node Detection in Early-Stage Oral Squamous Cell Carcinoma Using Magnetic Resonance Lymphography: A Pilot Study. Journal of Clinical Medicine, 13(23), 7052. https://doi.org/10.3390/jcm13237052

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