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A surface-modified chylomicron remnant-like emulsion for percutaneous computed tomography lymphography: synthesis and preliminary imaging findings.

RATIONALE AND OBJECTIVES: To assess a surface-modified emulsion as a percutaneous CT lymphographic agent in normal dogs. METHODS: An iodinated chylomicron remnant-like microemulsion was formulated with a mean particle size of 91.3 nm and an iodine concentration of 91 mg I/mL. Contrast material (2 mL) was injected into the subcutaneous tissues of the metatarsus and metacarpus of six normal dogs to enhance popliteal and cervical lymph nodes, respectively. CT images were acquired at 0, 15, 30, 45, 60, 240, 480, and 1440 minutes. RESULTS: Significant lymph node enhancement occurred in as little as 15 minutes after injection and persisted at least 8 hours. Node opacification was most pronounced at 1 to 4 hours postinjection and exceeded 200 HU in some nodes (precontrast attenuation = 45 HU). Marked enhancement of popliteal efferent lymphatics and of iliac and sacral node groups also occurred indicating distribution to second order nodes. Attenuation of enhanced nodes reverted to precontrast levels by 24 hours. CONCLUSION: The new surface-modified, chylomicron remnant-like emulsion provided marked, selective enhancement of targeted lymph nodes after subcutaneous administration. Moreover, the formulation produced significant opacification of more distant node groups from a single injection.

Animals↗

The value of lymphography in the management of bladder cancer.

228 bilateral pedal lymphograms in patients with bladder cancer have been correlated with the features of the primary bladder tumour and patient survival. In 70 cases, radiographic findings were correlated with operative node histology. The results show that it is not possible to predict accurately which cases have lymphatic spread without this investigation. Positive lymphograms were found in 91 cases, and were associated with a very poor prognosis. Only 6% of patients with unilaterally involved iliac nodes survived 5 years, and all patients with bilateral iliac or para-aortic disease died within 3 years. Histological correlation was found in 90% of cases, and the results indicate that this investigation slightly underestimates the incidence and extent of microscopic lymphatic metastases. It is concluded that this investigation is essential in planning the treatment of infiltrating bladder tumours.

Follow-Up Studies↗

Lymphography.

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