In:
The Laryngoscope, Wiley, Vol. 124, No. 11 ( 2014-11), p. 2531-2536
Abstract:
Sentinel lymph node biopsy (SLNB) has been utilized for cutaneous melanoma and other malignancies arising from the eye and ocular adnexa. Currently, SLNB requires blue dyes and/or radiopharmaceuticals; both of which have significant shortcomings. This study sought to evaluate the feasibility of SLNB with the use of real‐time, contrast‐enhanced ultrasound (CEUS) as an alternative technique for tumors arising in the conjunctiva. Study Design Prospective feasibility study in a porcine model. Methods Twelve experiments were performed on six non–tumor‐bearing Yorkshire swine. An ultrasound contrast agent, Sonazoid (GE Healthcare, Oslo, Norway), 99m technetium ( 99m Tc), and methylene blue (MB) (Covidien, Mansfield, MA) were injected in the ocular conjunctiva. Sentinel lymph nodes (SLNs) were localized with CEUS and findings were compared to that of MB and 99m Tc. Fisher exact test was used. Results Contrast‐enhanced SLNs were identified within an average of 6.2 minutes from time of injection of Sonazoid. A total of 17 SLNs were identified by at least one of the three techniques. Correlation between Sonazoid and 99m Tc was 94.1% (16/17 SLNs). Correlation between 99m Tc and MB was 88.2% (15/17). One SLN that was positive for 99m Tc but negative for Sonazoid and was considered to be a false positive (1/17); findings were similar for MB (1/17). Differences between the three techniques were not significant ( P = .886). Conclusions CEUS‐guided injection of conjunctiva for SLNB is technically feasible and correlates well with standard detection techniques. This technique shows promise for rapid, real‐time, intraoperative imaging for SLNB, using a widely available imaging modality and avoiding the need for radiopharmaceuticals. Level of Evidence NA Laryngoscope , 124:2531–2536, 2014
Type of Medium:
Online Resource
ISSN:
0023-852X
,
1531-4995
DOI:
10.1002/lary.v124.11
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2026089-1
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