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Preoperative imaging of sentinel lymph nodes in gastric cancer using CT lymphography

 Woo Jin Hyung  ;  Yong Soo Kim  ;  Joon Seok Lim  ;  Myeong-Jin Kim  ;  Sung Hoon Noh  ;  Ki Whang Kim 
 YONSEI MEDICAL JOURNAL, Vol.51(3) : 407-413, 2010 
Journal Title
Issue Date
Adult ; Aged ; Female ; Humans ; Iopamidol ; Lymph Nodes/diagnostic imaging* ; Lymph Nodes/pathology ; Lymphography/methods* ; Male ; Middle Aged ; Models, Biological ; Preoperative Care ; Sentinel Lymph Node Biopsy ; Stomach Neoplasms/diagnostic imaging* ; Stomach Neoplasms/pathology ; Tomography, X-Ray Computed/methods*
Gastric cancer ; sentinel lymph nodes ; preoperative imaging ; lymphography
PURPOSE: Preoperative identification of the sentinel lymph node (SLN) in gastric cancer (GC) patients may have great advantages for the minimally invasive treatment. This study was performed to evaluate the possibility of preoperative SLN detection using CT lymphography. MATERIALS AND METHODS: Fourteen patients with early GC were enrolled. CT images were obtained before and at 1, 3, and 5 minutes after endoscopic submucosal peritumoral injection of 2 mL iopamidol. For patients with clearly identified SLNs, to make comparisons with the CT lymphography results, intraoperative SLN detection was performed using subserosally injected Indocyanine green (ICG) lymphography and ex vivo ICG and iopamidol lymphography using mammography was also performed. RESULTS: CT lymphography clearly visualized draining lymphatics and SLNs in 4 (28.6%) out of 14 patients. All clearly visualized SLNs (one to three SLNs per patient) under preoperative imaging were detected in the same location by intraoperative ICG lymphography and ex vivo ICG and iopamidol lymphography using mammography. All preoperative SLN detections were observed with the primary tumors in the lower third of the stomach. CONCLUSION: Although our study demonstrated a SLN detection rate of less than 30%, CT lymphography with radio-contrast showed potential as a method of preoperative SLN detection for GC
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Yong Soo(김용수)
Noh, Sung Hoon(노성훈) ORCID logo https://orcid.org/0000-0003-4386-6886
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
Hyung, Woo Jin(형우진) ORCID logo https://orcid.org/0000-0002-8593-9214
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