Abstract
Objective To investigate the potential use of indirect computed tomography lymphography (CT-LG) with dendrimer-entrapped gold nanoparticles (Au DENPs) in the localization and enhanced imaging of cervical sentinel lymph node (SLN) on rabbit model. Methods Twelve rabbits were randomly divided into two groups: the positive control group and the experimental group. In the control group, indirect CT-LG was performed with the injection of 0.5 ml activated carbon nanoparticles (ACNP) and Omnipaque mixture suspension in the right tongue submucosa. CT images were acquired before the injection and 1, 5, 10, and 15 min after the injection, respectively. In the experimental group, indirect CT-LG injection with 0.5 ml Au DENPs suspension was performed in the right tongue submucosa. CT images were obtained before the injection and 1, 5, 10, and 15 min and 1, 2, 6, 24, 48, and 72 h after the injection, respectively. Then, SLN identification and enhancement characteristics were evaluated. Results Indirect CT-LG revealed the enhancement of one right deep cervical lymph nodes in all animals, which was SLN. SLN location was marked with black color (ACNP dye) or purple-black color (Au DENPs dye). At each detection time point, the enhanced SLN attenuation values of control rabbits were statistically significantly higher than that of the plain scan, respectively (P < 0.05). Also the values of experimental rabbits were statistically significantly higher than that of the control at the same time point after injection (P < 0.05). The detection rate of SLN was 100%. Conclusions Indirect CT-LG with injection of Au DENPs as CT contrast agents can locate the SLN for a long period of time and enrich the SLN black dye. It is helpful for SLNs identification during the operation.
Highlights
Cervical lymph node metastases are often noted in squamous cell carcinoma of the head and neck, such as tongue, supraglottic, and hypopharyngeal cancers
Sentinel lymph node (SLN) is the first draining lymph node or group of lymph nodes that is reached by metastatic tumor cells from a primary cancer lesion [2], and SLN status as an important marker could reflect the status of the whole group of drainage lymph nodes
Au DENPs have a higher X-ray attenuation intensity than the mixture of Omnipaque and the nanocarbon particle, making it a promising potential contrast which may be more effective than Omnipaque
Summary
Cervical lymph node metastases are often noted in squamous cell carcinoma of the head and neck, such as tongue, supraglottic, and hypopharyngeal cancers. The accurate diagnosis of the cervical lymph node metastases is crucial for carcinoma staging, therapy, and prognosis. The suspected patients could undergo invasive sentinel lymph node biopsy (SLNB) to have their metastases status staged accurately [3]. SLNB often used blue dye, activated carbon nanoparticles (ACNP) tracing dyes, and radionuclide tracer techniques alone or two in combination. The radionuclide tracer technique with lymphoscintigraphy is confined to intrinsically poor spatial resolution for imaging anatomic details. It features radioactive contamination and is only available in nuclear medicine department. Current noninvasive methods to identify SLNs have been clinically used to obtain imaging pictures and mapping location of SLN in vivo, for example, magnetic resonance imaging (MRI), computed tomography
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