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PubMedDate not supplied

Interstitial magnetic resonance lymphography: comparative animal study of gadofluorine 8 and gadolinium diethylenetriamine-pentaacetic acid.

PURPOSE: We evaluated the usefulness of gadofluorine 8 (G8) and gadolinium diethylenetriamine-pentaacetic acid (Gd-DTPA) for interstitial magnetic resonance lymphography (MRL). METHOD: Phantom imaging studies were conducted with G8 and Gd-DTPA corresponding to 0.1-0.005 micromol Gd/mL, and signal intensity was measured. Popliteal lymph node (PLN) accumulation was investigated in rabbits. Imaging was performed before and after subcutaneous administration of G8 (50 micromol Gd/mL) and Gd-DTPA (50 micromol Gd/mL). Contrast enhancement ratio measurements of PLN were determined both prior to and following the administration. RESULTS: Signal intensity of phantom for G8 are higher than those for Gd-DTPA from 0.1 to 0.002 micromol Gd/mL (P < 0.0001). Imaging after 5 minutes can clearly detect PLN accumulation on two contrast agents. Nevertheless, PLN accumulation of Gd-DTPA disappeared after about 30 minutes. A statistically significant difference between G8 and Gd-DTPA can be seen from 5 to 90 minutes in CER (P < 0.0001). PLN became clearly visible at 5 minutes after the injection of G8 and Gd-DTPA. Nevertheless, PLN accumulation of Gd-DTPA disappeared at 30 minutes. Otherwise, PLN accumulation of G8 continued up to 90 minutes. CONCLUSION: These studies indicated that G8 was more suitable than Gd-DTPA as a contrast agent for interstitial MRL up to 90 minutes.

Animals↗
PubMed2004

Computed tomography lymphography with intrapulmonary injection of iopamidol for sentinel lymph node localization.

PURPOSE: Experimental and clinical evaluation of the potential utility of indirect computed tomographic lymphography (CT-LG) with intrapulmonary injection of iopamidol for preoperative localization of sentinel lymph node station in non-small cell lung cancer. METHODS: CT-LG with intrapulmonary injection of 0.5 mL of undiluted iopamidol was performed in 10 dogs using a multidetector-row CT unit, followed by postmortem examination of enhanced lymph nodes in 5 of these dogs. The CT-LG with peritumoral injection of 1 mL of the contrast agent was also performed in 9 patients with non-small cell lung cancer without lymphadenopathy. At surgery, enhanced lymph nodes were resected under CT-LG guide, followed by standard lymph node dissection with macroscopic and histologic examination. A significant enhancement of lymph nodes was determined when CT attenuation value was increased with 30 Hounsfield units (HU) compared with precontrast images. RESULTS: CT-LG visualized a total of 15 enhanced lymph nodes (on average, 1.5 nodes per animal) within 2 minutes after contrast injection in the 10 dogs, with average size of 6.7+/- 1.9 mm and average maximum CT attenuation of 149 +/- 41 HU. All the 8 enhanced nodes in 5 dogs were found in the appropriate anatomic locations in postmortem examinations. Without noticeable complications, CT-LG visualized 30 ipsilateral intrathoracic lymph nodes including 19 hilar/pulmonary and 11 mediastinal nodes in the 9 patients (on average, 2.2 hilar/pulmonary and 1.1 mediastinal nodes per patient) within 2 minutes after contrast injection, with average size of 4.7+/- 0.4 mm and average maximum CT attenuation of 134 +/- 52 HU. At surgery, all these enhanced nodes could be accurately found and resected under CT-LG guidance. Metastasis was not evident in either of these enhanced lymph nodes or the remaining distant nodes in all patients. CONCLUSION: Quick and accurate localization of sentinel lymph node station on detailed underlying lung anatomy by using indirect CT-LG may be of value to guide selective lymph node dissection for minimally invasive surgery in non-small cell lung cancer.

Aged↗
PubMed1995

Has lymphography a role in early stage testicular germ cell tumours?

A retrospective study was performed of 183 newly diagnosed seminoma cases and 73 newly diagnosed non-seminomatous germ cell tumours (NSGCT) presenting from 1985 to 1989 to a tertiary referral cancer hospital. The purpose was to assess the contribution of bipedal lymphography (LG) to the management of these patients. As the main value of LG is in detecting small retroperitoneal lymph node (LN) metastases, analysis concentrated upon early stage disease, specifically N0 and N1a LN disease. Comparison between LG results, abdominopelvic computed tomography (APCT), final clinical stage and treatment outcome was performed. We found that with the LG and APCT criteria used (filling defects > 2 mm and LN diameter > 20 mm, respectively), LG was much more sensitive in disease detection. However, with modern techniques APCT can reliably detect disease 10 mm or greater. In addition, tumour marker status, primary tumour vascular invasion status and initial clinical examination were each more important in staging NSGCT disease than LG alone. Thus, LG is now rarely used in our institution but we will have to monitor our excellent survival data to confirm that this change in policy is warranted.

Adult↗
PubMed2006

Lymphography of the thoracic duct by percutaneous injection of iohexol into the popliteal lymph node of dogs: experimental study and clinical application.

OBJECTIVE: To evaluate the efficacy of percutaneous administration of iohexol into the popliteal lymph node as a non-invasive technique for thoracic duct lymphangiography in dogs. STUDY DESIGN: Experimental study and clinical report. ANIMALS: Normal adult dogs (n=4) and 1 dog with recurrent chylothorax. METHODS: For the experimental study, 4 dogs (weight, 8.4-12.3 kg) had 5-10 mL iohexol injected percutaneously into 1 popliteal lymph node and then thoracic radiographs were taken. Popliteal lymph nodes were examined by histopathology 8 days later. One 25-kg dog with recurrent chylothorax had 25 mL iohexol injected into the right popliteal lymph node followed by thoracic radiography. RESULTS: In experimental dogs, the thoracic duct was best visualized on thoracic radiographs after administration of 10 mL iohexol. Clinically, no abnormalities were identified in the injected limb and except for 1 dog that had large numbers of siderocytes and erythrophagocytic macrophages in the injected lymph node, the histopathologic findings in the other injected popliteal lymph nodes were not different from contralateral nodes. In the clinical case, the thoracic duct was visualized, but there was leakage of iohexol around the node. CONCLUSION: The thoracic duct in dogs can be visualized by lymphography after percutaneous injection of iohexol (1 mL/kg at 2 mL/min) into the popliteal lymph node. CLINICAL RELEVANCE: Percutaneous popliteal lymph node administration of iohexol should be considered as an alternative to mesenteric lymph node injection for radiographic identification of the thoracic duct in dogs.

Animals↗
PubMedDate not supplied

Quantitative methods for indirect CT lymphography.

In this investigation, we applied quantitative CT methods to characterize contrast enhanced lymph nodes opacified using iodinated contrast media for indirect CT lymphography. Iodinated nanoparticles were injected into the buccal submucosa and SQ into the metatarsus and metacarpus of four normal swine (1.0-4.0 ml/site, 76 mg I/ml). Attenuation (HU), volume (cm3), iodine concentration (mg I/cm3), total iodine uptake (mg I), contrast-to-noise ratio (CNR), and percent injected dose (%ID) were estimated in opacified inguinal, cervical and parotid/mandibular lymph nodes using manual image segmentation techniques on 24 hour post-contrast CT images. Lymph node volumes estimated by multiple slice ROI analysis were compared with estimates obtained by post-excisional weight measurements. HU and iodine concentration increased 5-20 fold in opacified nodes (p < 0.01) and CNR increased more than four-fold (p < 0.001). %ID ranged between 3.5 and 11.9% and did not appear dose related. ROI estimated lymph node volumes approximated volumes calculated from weight measurements. (R2 = 0.94, p < 0.0001). We conclude that interstitially injected iodinated nanoparticles increase attenuation and conspicuity of targeted nodes on CT images. Quantitative methods could play an important clinical role in more accurate metastasis detection.

Animals↗
PubMed1975

Repeat Lymphography in Non-Hodgkin's Lymphoma.

Thirty-nine patients with non-Hodgkin's lymphoma underwent repeat lymphography. The radiographic findings and effects on clinical management are discussed. The repeat examinations were technically no more difficult to perform than the initial studies. Repeat lymphograms were positive for tumor in 44% of cases. Positive findings were more frequent in patients who received no prior subdiaphragmatic irradiation or in whom the initial study demonstrated lymphomatous infiltration. Interpretative problems include reactive hyperplasia, post-irradiation lymph node alterations, and the lymph nodal distortion occasionally encountered in the treated lymph node which had been involved with tumor.

Adolescent↗
PubMed1975

Retrograde hepatography and indirect lymphography of the liver: an experimental study in the dog.

Retrograde infusion of large amounts of water-soluble contrast agents into the biliary system results in only a brief hepatogram. A dense hepatogram lasting for several weeks and visualization of hepatic and celiac lymph nodes equal to that in direct lymphography can be obtained after retrograde biliary infusion of Ethiodol. In serching for metastasis from tumor in the liver, gall-bladder, bile ducts, pancreas, stomach, and duodenum, radiographic visualization of these nodes may help. If proved safe, the procedure can be performed by endocopic cannulation of the common bile duct.

Animals↗
PubMed1976

Lymphography in clinically suspected lymphoma: a retrospective analysis of 63 cases.

Pedal lymphography was performed for 63 patients with clinical findings (chiefly unexplained pyrexia or splenomegaly) suggestive of lymphoma involving the retroperitoneal nodes. The lymphogram was abnormal in 17 cases. Lymphoma was found in 5, metastatic carcinoma in 3, malignant histiocytes in 1, and benign hyperplasia or fibrolipomatous nodal changes in 4 (histiological tests were not obtained in the other 4). An abnormal lymphogram of the retroperitoneal nodes constitutes an indication for laparotomy; the lymphographic appearance of lymphoma is nonspecific, and histologic confirmation should be sought.

Adolescent↗
PubMed1979

Lymphography without the use of vital dyes.

Pedal lymphography was performed without the use of vital dyes in 510 patients. Lymphatic vessels were still readily identifiable by this method, due to their transparency, clarity, elasticity, distensibility, and characteristic branching pattern. Procedure time was shortened by 10-15 minutes without compromising the high success rate.

Adolescent↗
PubMed1989

Non-Hodgkin lymphoma: influence of lymphography, CT, and bone marrow biopsy on staging and management.

This prospective study assesses the contribution of lymphography (LAG), abdominal-pelvic computed tomography (CT), and bone marrow biopsy to the staging and management of 168 consecutive cases of newly diagnosed non-Hodgkin lymphoma (NHL). LAG and/or CT influenced Ann Arbor clinical stage (CS) in 39 patients (23%) and Ann Arbor pathologic stage (PS) in 23 patients (14%) by detection of clinically inapparent retroperitoneal adenopathy and/or extranodal disease. LAG findings raised the CS in eight patients and the PS in six of the eight by showing adenopathy when the CT results were negative. By depicting extranodal disease, CT resulted in the CS being raised in an additional ten patients and the PS in six of the ten. Of the diagnostic tests assessed, bone marrow biopsy and/or cytology had the greatest influence on staging. Clinical staging that included LAG/CT resulted in the identification of only 30 patients with CS IV disease, whereas an additional 53 CS I through CS III patients had their disease stage raised to PS IV due to positive bone marrow biopsy/cytology results. However, 42 of the 53 patients already had advanced (CS III) disease. Initial case management was influenced by LAG, CT, or bone marrow biopsy/cytology results in 27 of 168 patients. LAG/CT results influenced management in 20 of 27 cases, while bone marrow biopsy/cytology results caused initial management changes in only seven of the 27 cases.

Adolescent↗
PubMed1999

Cerebral and renal embolization after lymphography in a patient with non-Hodgkin lymphoma: case report.

An unusual case of lipid embolization to brain and kidney after lymphography in a patient with non-Hodgkin lymphoma of the upper anterior mediastinum is reported. Contrast material-enhanced echocardiography demonstrated a right-to-left shunt to the left atrium without evidence of a patent foramen ovale. Echo contrast particles were transiently present within the tumor surrounding the great vessels.

Adult↗
PubMed2001

Interstitial T1-weighted MR lymphography: lipophilic perfluorinated gadolinium chelates in pigs.

PURPOSE: To investigate the enhancement of the regional lymph nodes, lymphatic vessels, and thoracic duct after interstitial administration of lymphotropic perfluorinated gadolinium chelates at magnetic resonance (MR) imaging. MATERIALS AND METHODS: Two perfluorinated gadolinium chelates, gadofluoramide and gadofluorine 8, were injected subcutaneously into the hind legs of 10 pigs, respectively. Both contrast media were studied at doses of 10 and 25 micromol per kilogram of body weight. T1-weighted three-dimensional gradient-echo and maximum intensity projection images were obtained at 1.5 T between 1 and 210 minutes and 24 hours after injection. The contrast agents were qualitatively compared regarding enhancement and depiction of the regional lymph nodes, lymphatic vessels, and thoracic duct. RESULTS: The inguinal and iliac lymph nodes and lymphatic vasculature enhanced substantially within 10 minutes after subcutaneous administration of both lymphotropic contrast agents. Gadofluorine 8 showed a lymphographic effect superior to that of gadofluoramide. The paraaortic lymph nodes and thoracic duct were best visualized 10--50 minutes after injection of 25 micromol/kg of gadofluorine 8. Lymphatic system enhancement diminished after 2 hours, and the liver and bowel tract enhanced within 24 hours. CONCLUSION: Interstitial administration of perfluorinated gadolinium chelates offers great potential for T1-weighted MR lymphography with positive enhancement of the lymph nodes and lymphatic vasculature.

Animals↗
PubMed1977

The value of lymphography for the TNM classification of renal carcinoma.

Preoperative lymphography is a basic condition for uniform tumor classification of renal carcinoma, according to the T, N and M categories. The comparison of 148 lymphographic findings with 170 intraoperative and histopathological lymph node results showed a satisfactory correlation. The total frequency of lymph node metastasis was of 21.6%. Carcinomas with positive lymph nodes showed a significant increase of far distant metastasis up to 50%. Lymph node metastases have to be considered in 10% of all carcinomas of the T1 and T2 categories and in 15.5% of the cases with unclear preoperative lymphographic diagnosis. These results point out the necessity of a radical lymphadenectomy in all T categories.

Adult↗
PubMed1978

Percutaneous indirect lymphography with a new experimental contrast medium: a preliminary report.

Suspension of tetraiodotheraphtalic acid-bis-oxyethylester (120-480 mg I/ml) was injected percutaneously into the testicles, mammary glands, and the cervix of the uterus in mongrel dogs. The suspension was rapidly absorbed by the lymphatics draining the injection sites and transported to the regional lymph nodes. Excellent filling of lymphatics and nodes was apparent immediately or a few minutes after injection. Because of locally produced inflammatory reaction, percutaneous indirect lymphography with tetraiodotherephtalic acid-bis-oxyethylester is now applicable only in experimental animal studies.

Animals↗
PubMed1977

Phlebography, urography and lymphography in the diagnosis of metastases from testicular tumors.

The value of lymphography from the foot, urography and phlebography of the inferior vena cava and the left renal and testicular veins in the search for retroperitoneal metastases was investigated in 120 patients with testicular tumors. Phlebography of the left renal and testicular veins was a valuable supplement to the other examinations, so that the combined use of all these methods is recommended in demonstrating metastases and in evaluating the extent of growth and effect of treatment.

Adolescent↗