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At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Visualization of lymphatic basin from the tumor using magnetic resonance lymphography with superparamagnetic iron oxide in patients with thoracic esophageal cancer.

OBJECTIVE: To evaluate magnetic resonance (MR) lymphography with submucosal injection of superparamagnetic iron oxide (SPIO) for imaging lymphatic pathways from thoracic esophageal cancer. METHODS: In 24 patients with esophageal cancer, SPIO was injected into the submucosal layer of the peritumoral region endoscopically and MR lymphography was conducted. In study 1, fast spoiled gradient-recalled acquisition using a steady-state (FSPGR) sequence was performed from the neck to the upper abdomen before and at 20, 40, and 60 minutes after injection in 10 patients. In study 2, FSPGR and spin echo T1-weighted images were obtained after injection in 14 patients. Areas scanned were the neck to the upper mediastinum and the upper abdomen. RESULTS: In study 1, at 20 minutes after injection, the signal of each lymph node appeared attenuated when compared with precontrast images. The signal-to-noise ratio in lymph nodes exhibiting influx of SPIO was significantly lower than that found on precontrast images (P < 0.0005). In study 2, influx to the neck lymph nodes was detected in 8 patients (64.3%), whereas influx to the upper abdominal lymph nodes was detected in 13 (92.9%). CONCLUSIONS: Magnetic resonance lymphography with SPIO could visualize the lymphatic pathways draining from the injection site and the location of lymph nodes exhibiting influx of SPIO in patients with thoracic esophageal cancer.

Adult↗
PubMed2003

Potential of magnetic resonance lymphography with intrapulmonary injection of gadopentetate dimeglumine for visualization of the pulmonary lymphatic basin in dogs: preliminary results.

PURPOSE: To evaluate a new approach of magnetic resonance (MR) lymphography with intraalveolar injection of a conventional extracellular contrast agent (gadopentetate dimeglumine) for imaging lymphatic basin draining from specific portions of the lung. METHODS: Three-dimensional T1-weighted spoiled gradient-recalled echo MR sequence images were acquired serially before and for 40 minutes after intraalveolar injection of gadopentetate dimeglumine in a total of 14 anesthetized beagle dogs. Six of these dogs received 1 mL undiluted and low-concentration (75%) contrast agent into the same portion of the right caudal lobe during a 7-day interval. In all dogs, including these 6 dogs, MR lymphography was repeated with injection of the low-concentration contrast agent into different lung regions at 7-day intervals to evaluate the differences of the visualized draining lymphatic station. Lymphatic enhancement was quantified by percent increases of signal intensity against precontrast. Postmortem examination of the lymphatic anatomy was performed in 7 of these animals. RESULTS: In all dogs, the lymphatic station draining from the injection sites was visualized within 5 minutes after contrast injection. The maximum percent increase of signal intensity of the same middle tracheobronchial lymph nodes was significantly greater with a low-concentration (75%) contrast agent than with an undiluted one in the same 6 dogs (n = 6, 247.6 +/- 30.5% vs. 204.2 +/- 33.8%; P < 0.01). Different lymphatic stations draining from the different injection sites were visualized in all dogs. In a total of 12 MR studies that showed extended nodal enhancement after injection of the low-concentration contrast agent, the enhancement peak of the most proximal nodes (n = 12) from the injection sites appeared earlier than that of their distant nodes (n = 12), with a maximum percent increase of signal intensity of 249.8 +/- 42.4%. The visualized lymph nodes were found in the appropriate locations postmortem, with significant correlation for nodal sizes (r = 0.965; P < 0.0001). CONCLUSION: MR lymphography with low-concentration gadopentetate dimeglumine can quickly and sufficiently visualize the drainage lymphatic station from specific lung portions, and may have the potential of sentinel node mapping in lung cancer.

Animals↗
PubMed2005

Interstitial magnetic resonance lymphography using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid in rabbits with lymph node metastasis.

RATIONALE AND OBJECTIVES: To investigate the dose dependency of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) for interstitial magnetic resonance (MR) lymphography and the detection of lymph node metastasis in rabbits. METHODS: Eighteen VX2 tumor-bearing rabbits were subjected to MR lymphography using clinical MRI equipment. The enhancement of popliteal lymph nodes was studied in these rabbits before and at 2.5 to 10 minutes after the subcutaneous administration of 4, 8, or 17 micromol Gd/kg of Gd-EOB-DTPA in TSE and 3D-FLASH (n = 6). Signal-to-noise ratio and contrast-to-noise ratio were statistically compared between each group by the Tukey test. After MR imaging, the popliteal lymph nodes were removed, and sections were prepared for microscopic examination. RESULTS: In the histologic findings, all metastases (3-12 mm) in the popliteal lymph nodes were detected by 3D-FLASH images. Gd-EOB-DTPA-enhanced T1WI showed a hypointense region for metastasis and a hyperintense region for nontumor regions, although the lymph nodes containing metastasis were detected as a hyperintense region by conventional PDWI and T2WI. Signal enhancement of the nontumor regions and contrast between the nontumor regions and metastasis showed dose dependency and reached a plateau at 8 micromol Gd/kg on T1WI (signal-to-noise ratio: 13.9 +/- 1.6; contrast-to-noise ratio: -12.7 +/- 1.7). CONCLUSIONS: This study showed that interstitial MR lymphography with Gd-EOB-DTPA can detect metastasis and that the optimal dose in rabbits is 8 micromol Gd/kg as a subcutaneous application.

Animals↗
PubMed1993

Interstitial MR lymphography with iron oxide particles: results in tumor-free and VX2 tumor-bearing rabbits.

OBJECTIVE: MR lymphography with interstitial injection of superparamagnetic iron oxide particles was optimized in normal rabbits by investigating the pattern of signal reduction in lymph nodes as a function of dose and time after administration. The optimized examination procedure was then used in a rabbit tumor model to study the potential of superparamagnetic iron oxide--enhanced MR lymphography in the detection of metastatic lymph node involvement. MATERIALS AND METHODS: The popliteal and iliac lymph nodes of 18 normal rabbits were imaged to study the dose response and time course of the effect of the contrast agent. For the dose response study, six doses of 2-50 mumol of iron per extremity were administered to three animals per dose, and MR images were obtained before and 12 hr after administration. For the time course study, 20 mumol of iron per extremity was administered to four animals, and images were obtained before and 6 hr to 42 days after administration. VX2 tumor-bearing rabbits were examined 12 hr after administration of 20 mumol (10 animals) and 50 mumol (three animals) of iron per extremity. Superparamagnetic iron oxide was injected into the foot pad of the hind limb. T1-, T2-, and proton density-weighted MR images were obtained with a 1.5-T unit. RESULTS: In normal rabbits, a profound and homogeneous loss of signal intensity was found with doses of 2-5 mumol of iron per extremity in popliteal lymph nodes and with doses of 20-30 mumol in the iliac lymph nodes. Superparamagnetic iron oxide caused maximal loss of signal intensity in both popliteal and iliac lymph nodes 12 hr after administration. In tumor-bearing rabbits, different degrees of metastatic displacement of lymph nodes were discernible, and even small metastases (3 mm in diameter) could be visualized when using the optimized examination protocol and the proton density-weighted spin-echo sequence. CONCLUSION: We conclude that interstitial MR lymphography with superparamagnetic iron oxide enables the detection of lymph node metastases and therefore is a promising technique for improved diagnostic imaging of lymph nodes in the staging of tumors.

Animals↗
PubMedDate not supplied

Study of the lymph flow of the cardia by endoscopic RI-lymphography with SPECT.

Endoscopic RI-lymphography was performed in 29 patients, with single photon emission computed tomography (SPECT) also performed in 19 of them. The lymph flow from the cardia was directly evaluated in lymphograms and compared with the RI uptake of each lymph node and the incidence of lymph node metastasis of previously resected carcinoma of the cardia in patients according to the location of the lymph node. Endoscopic RI-lymphography performed in combination with SPECT was considered to be highly useful for imaging lymph flow of the cardiac region. SPECT and RI-lymphography indicated rich lymph flow from the cardia to the periaortic region, and this finding was consistent with the incidence of lymph node metastasis according to the location of the lymph node in patients who had previously undergone resection of cancer of the cardia. Careful examination for metastasis to lymph nodes around the abdominal aorta was considered to be necessary, especially in patients with carcinoma of the cardia.

Cardia↗
PubMed1979

Severe pulmonary hemorrhage following lymphography.

The hemoptysis which occurs following lymphography typically consists of one or more episodes of blood-tinged sputum, and generally requires no treatment. In contradistinction to this "mild" form of hemoptysis, the current report describes a case of hemoptysis following lymphography--hemoptysis so severe as to require multiple transfusions. Time course and possible etiologic factors are discussed.

Blood Transfusion↗
PubMed1982

Lymphography in the diagnosis of non-seminoma tumours of the testis.

In a series of 86 lymphograms correlated to histological findings after retroperitoneal lymph node dissection or to laparotomy findings, reliability proved to be 78%. The reliability of lymphograms evaluated as positive was 88%, while that of negative lymphograms was 74%. Retroperitoneal lymph node metastases were detected with the aid of lymphography in 58% of the patients. It was impossible to establish a node size above which metastases could be demonstrated with certainty by lymphography.

Humans↗
PubMed1979

Reliability of lymphography as a diagnostic aid in the planning of treatment for bladder carcinoma.

To assess the accuracy of lymphography, 90 lymphograms were compared with surgical and histological findings. Histological correlation with the initial report was found in 65 to 90 cases (72%). Comparison of the original radiologist's report with a recent re-examination showed agreement between the two radiological evaluations in only 74%. Although improvement in diagnostic accuracy can perhaps be obtained, we cannot yet recommend lymphography as an aid in the planning of treatment for bladder carcinoma.

Humans↗
PubMed2004

Preoperative imaging of the lung sentinel lymphatic basin with computed tomographic lymphography: a preliminary study.

BACKGROUND: Preoperative localization of the sentinel node basin would guide selective lymph node dissection. We tried to identify these nodal stations with indirect computed tomographic lymphography using a conventional extracellular contrast agent, iopamidol. METHODS: Eleven consecutive patients scheduled to undergo anatomic resection of suspected lung cancer, without lymphadenopathy, were given a peritumoral injection of undiluted iopamidol under computed tomography guidance, and lymphatic migration was assessed by multidetector-row helical computed tomography. RESULTS: There were no complications such as bleeding, pneumothorax, or allergic reactions. Enhanced nodes were detected in all but 1 patient who had diffuse lymph nodal calcification. Enhanced nodes were identified at 32 ipsilateral intrathoracic nodal stations (20 hilar stations and 12 mediastinal stations). The average length of the longer axis of the enhanced nodes was 4.8 mm (range, 3 to 8 mm), and the average attenuation of the enhanced nodes was 132 (range, 46 to 261) Hounsfield units. In 9 patients with confirmed lung cancer, enhanced nodes appeared at 26 nodal stations, and all apparent enhanced nodes were identified as actual lymph nodes at appropriate position during lymphadenectomy. None of the resected lymph nodes had metastatic involvement. CONCLUSIONS: Indirect computed tomographic lymphography with the peritumoral injection of iopamidol effectively depicts the drainage nodes unless they are diffusely calcified. Although further study is required, this method could guide selective lymph node dissection.

Aged↗
PubMed1986

The value of lymphography in the management of carcinoma of the cervix.

Lymphography has been used to evaluate the pelvic and para-aortic nodes in 205 patients with carcinoma of the cervix treated between 1970 and 1979. The incidence of positive nodes was found to be 17% for Stage I, 24% for Stage II, 52% for Stage III and 100% for Stage IV. Of 73 patients who had lymphograms before Wertheim's hysterectomy, four out of 59 patients (7%) with negative lymphograms had histologically positive nodes; four out of 14 (28%) with positive lymphograms had negative nodes. Within each FIGO stage a positive lymphogram indicated a poor prognosis. The actuarial 5-year survival rates for patients with negative and positive lymphograms were 94% and 55% respectively for Stage I, 72% and 64% for Stage II, and 34% and 17% for Stage III. Of 39 patients with positive lymphograms who died of tumour, 31 out of 39 (80%) had distant metastases, compared with nine out of 29 patients (31%) with negative lymphograms. It is concluded that lymphography is a valuable method of evaluating lymph node status in carcinoma of the cervix.

Adult↗
PubMed2000

Iron oxide-enhanced MR lymphography: initial experience.

The detection of nodal metastases is of utmost importance in oncologic imaging. Ultrasmall superparamagnetic iron oxide particles (USPIO) are novel contrast agents specifically developed for MR lymphography. After intravenous administration, they are taken up by the macrophages of the lymph nodes, where they accumulate. They reduce the signal intensity (SI) of normally functioning nodes on postcontrast T2-and T2*-weighted images through the magnetic susceptibility effects on iron oxide. Metastatic nodes, in which macrophages are replaced by tumor cells, show no significant change in SI on postcontrast T2-and T2*-weighted images. Early clinical experience suggests that USPIO-enhanced MR lymphography improves the sensitivity and specificity for the detection of nodal metastases. It also suggests that micrometastases could be detected in normal-sized nodes. This article reviews the physiochemical properties of USPIO contrast agents, their enhancement patterns, and early clinical experience.

Contrast Media↗
PubMed1995

Indirect computed tomography lymphography of subdiaphragmatic lymph nodes using iodinated nanoparticles in normal dogs.

RATIONALE AND OBJECTIVES: We evaluated the imaging characteristics of an iodinated particulate contrast agent for indirect computed tomography (CT) lymphography of normal subdiaphragmatic lymph nodes in dogs. METHODS: Four milliliters of a 15% (wt/vol) iodinated nanoparticle suspension was injected into the gastric, colonic, rectal, or cervical submucosa, loose paraprostatic fascia, or metatarsal subcutaneous tissues in 10 healthy beagles. Endoscopic, CT, or ultrasound guidance was used when necessary to facilitate contrast agent delivery. CT and radiographic images were obtained prior to contrast administration and at 4 hr, 24 hr, and 7 days postcontrast injection. Postmortem examinations were then conducted. RESULTS: CT images showed enhancement of regional lymph nodes draining the various injection sites. The mean attenuation of opacified nodes was 678 +/- 463 Hounsfield units 24 hr after injection and remained elevated 7 days later. Lymph node opacification on CT images correlated well with the node location observed on postmortem examinations. CONCLUSION: Subdiaphragmatic lymph nodes can be effectively opacified using an iodinated nanoparticle contrast agent for indirect CT lymphography.

Abdomen↗
PubMed1994

Percutaneous computed tomography lymphography in the rabbit by subcutaneously injected nanoparticulates.

RATIONALE AND OBJECTIVES: Surgical lymphangiography is infrequently used in staging cancer because of its inherent limitations. Radiopaque nanoparticulates target lymph nodes draining interstitial tissues and could make percutaneous lymphography feasible. METHODS: Experimental nanoparticulate contrast agent formulations were injected subcutaneously in the forepaw or hindpaw of normal rabbits or rabbits with induced reactive nodal hyperplasia. Axillary and popliteal nodes were imaged with thin-section computed tomography (CT) using quantitative methods to measure node enhancement. Dose-response (0.1-2.0 ml) and time course (4 hr to 10 weeks) of enhancement were assessed. RESULTS: Nodal enhancement above 100 Hounsfield units was consistently obtained. Enhancement was significantly related to dose and peaked at 10 hr with slow washout over the observation period. Nodes with reactive hyperplasia were larger and had heterogeneous enhancement patterns distinctly different from normal nodes. CONCLUSION: Percutaneous CT lymphography effectively depicts the macroscopic intranodal architecture in rabbits.

Animals↗
PubMed1994

Time-lapse quantitative computed tomography lymphography: assessing lymphatic function in vivo.

RATIONALE AND OBJECTIVES: Immobility and massage produce different local limb lymph flow rates. We studied their influence on accumulation of radiopaque nanoparticulates in regional lymph nodes of normal rabbits. METHODS: Quantitative lymphography at 10-min intervals was used to follow the transport of subcutaneous (s.c.) nanoparticulates produced from insoluble esters of diatrizoic acid. In one design, both hindpaws received 0.5 ml of nanoparticulate s.c., and one hindpaw was massaged. In a second design, one hindpaw was injected and massaged while imaging the popliteal, presacral, and paraaortic nodes every 10 min. RESULTS: Gentle massage rapidly increased popliteal node accumulation in comparison with the immobile limb. On the massaged side, mean Hounsfield (HU) units, maximum Hounsfield units, and calculated iodine were significantly greater at 10 min and all subsequent times. In the node transfer experiments, it took 12, 30, and 45 min, respectively, to obtain 100-HU mean attenuation; 200-HU maximum attenuation thresholds were achieved at 20, 47, and 69 min, respectively. CONCLUSION: Quantitative computed tomography lymphography reflects local lymph physiology. Gentle massage of the s.c. injection site is a powerful lymphotropic stimulus.

Analysis of Variance↗
PubMed1976

[Results of gastric lymphography with particular reference to gastric carcinoma (author's transl)].

The regional lymph nodes of the stomach can be visualised radiologically by injecting Lipiodol Ultra-Fluid into the submucous layer of the stomach wall through a gastroscope. Lymphography was performed in gastrologically healthy probands (n = 10), in patients with gastroduodenal ulceration (n = 17), and in patients with gastric carcinoma (n = 35). In 28 of the gastric carcinoma patients the first order lymph nodes were demonstrated, in 21 cases the second order and in 15 cases the third order whereas defects in uptake indicated metastases in 16 patients which could be histologically confirmed in 13. Gastric lymphography may contribute to the indication for operation if metastases are suspected in the second and third order lymph nodes as nodes along the upper border of the pancreas and the coeliac trunk are very difficult to remove radically.

Female↗
PubMed1977

[The accuracy of lymphography in patients with malignant testicular tumours (author's transl)].

In 33 patients with malignant teratoid testicular tumours, the retro-peritoneal lymph nodes were surgically removed after lymphograms had been carried out. Histological examination of the lymph nodes showed retroperitoneal metastases in 42% (14 out of 33). In 25 of the 33 patients, there was agreement between lymphography and histology; diagnostic accuracy of lymphography was about 76%. In the presence of positive findings, accuracy was 87%.5%, for negative findings it was 72%. The more frequent false negative findings are due to anatomically determined failure of contrast filling of aortic lymph nodes; the less common false positive findings are produced by involution of lymph nodes.

Adolescent↗
PubMed1977

[The indications for lymphography in urology with special reference to carcinoma of the penis (author's transl)].

Lymphograms have been performed on 775 urological patients. Our experience indicates a scheme for lymphography in this particular speciality. According to this, carcinomas of the bladder and kidney are a relative indication for lymphography, whereas carcinomas of the scrotum, penis and prostate present an absolute indication. Fiftyseven lymphograms have been performed on 52 patients with carcinoma of the penis. In one patient the examination was carried out twice in one year, in another, three times and a third patient had three lymphograms over a period of six years. Most patients were aged 60 to 69 years, average age 61.48 years. Agreement between the histological and lymphographic findings was observed in 26 out of 34 patients treated surgically (76.5%).

Aged↗
PubMed1979

[Computer tomographic demonstration of lymph node metastases from malignant testicular tumours. A comparison of lymphography and computer tomography (author's transl)].

Lymphography and computer tomography was performed on 64 patients with malignant testicular tumours in order to demonstrate lymph node metastases. In 60 patients it was possible to confirm the findings by surgery. In 43 patients there was agreement between the findings of the computer tomogram and the lymphogram. In 39 of these patients lymph node metastases had been demonstrated, in three there was a false negative and in one a false positive. Amongst the patients in whom there was a descrepancy between the two types of examination, the CT findings were confirmed histologically in twelve, and the lymphographic findings in nine. In 12.5% CT added significant additional information. Accuracy of lymphography was 73% and of computer tomography 80%. Specificity for each examination was 79%.

Adult↗