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Correlative study of indirect computed tomography lymphography using iopamidol and histopathology in a cervical lymph node metastasis model

Authors

  • Yilai Shu PhD,

    1. Department of Otolaryngology–Head and Neck Surgery , EENT Hospital, Fudan University, Shanghai, China
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  • Xiuyin Xu MD,

    1. Department of Otolaryngology, Shanghai Seventh People's Hospital , Shanghai, China
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  • Ann M. Chodara BS,

    1. Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin, U.S.A.
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  • Michael F. Regner BS,

    1. Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin, U.S.A.
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  • Yan Sha MD,

    1. Department of Radiology , EENT Hospital, Fudan University, Shanghai, China
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  • Jack J. Jiang MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery , EENT Hospital, Fudan University, Shanghai, China
    2. Department of Surgery, Division of Otolaryngology–Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin, U.S.A.
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  • Mingliang Xiang MD,

    Corresponding author
    1. Department of Otolaryngology and Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai, China
    • Department of Otolaryngology and Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine,1665 Kong-Jing Road, Shanghai 200092, People's Republic of China
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  • Haitao Wu MD

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery , EENT Hospital, Fudan University, Shanghai, China
    • Department of Otolaryngology–Head and Neck Surgery, EENT Hospital, Fudan University, 83 FenYang Road, Shanghai 200031, People's Republic of China
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  • This study was supported by grant No. 09411967500 from the Science and Technology Commission of Shanghai Municipality, China. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To investigate the potential usefulness of indirect computed tomography lymphography (CT-LG) with iopamidol in the detection of cervical lymph node metastases in a VX2 rabbit tongue cancer model.

Study Design:

Randomized controlled trial.

Methods:

Thirty-seven rabbits were randomly divided into control (n = 7) and tongue tumor-bearing (n = 30) groups. In the control group, indirect CT-LG was performed with 0.5- and 0.25-mL injections of iopamidol in the right and left tongue submucosa, respectively. In the tumor-bearing group, indirect CT-LG with 0.5 mL of iopamidol was performed on day 11 (n = 8), 14 (n = 8), 21 (n = 8), or 28 (n = 6) after carcinoma transplant. The correlation between indirect CT-LG and histopathology was investigated.

Results:

In normal rabbits, oval or round enhanced cervical lymph nodes in each side of the neck were visualized by indirect CT-LG. In tumor-bearing rabbits, one enhanced lymph node on each side of the neck was visualized with or without filling defects in all rabbits except two on day 28 in which lymph nodes were not enhanced. The sensitivity, specificity, accuracy, and positive and negative predictive values for using filling defects on CT-LG as a diagnostic criterion were 77.4%, 77.8%, 77.6%, 80%, and 75%, respectively. Indirect CT-LG detected 84.6% of 2- to 6-mm intranodal tumor deposits.

Conclusions:

Indirect CT-LG may be useful for differentiating metastatic from nonmetastatic lymph nodes. Laryngoscope, 2011

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