Sentinel node detection in melanomas using contrast-enhanced ultrasound

K. Rue Nielsen; H. Klyver; A. Hougaard Chakera; L. Nedergaard; B. Hesse; M. Bachmann Nielsen

Sentinel node detection in melanomas using contrast-enhanced ultrasound

K. Rue Nielsen, H. Klyver, A. Hougaard Chakera, L. Nedergaard, B. Hesse, M. Bachmann Nielsen

Institut for Klinisk Medicin

12 Citationer (Scopus)

Abstract

BACKGROUND: Sentinel node (SN) biopsy has proven to be a useful clinical method based on the combination of radionuclide tracer principles and the dye technique. Contrast-enhanced ultrasound (CEUS) has been used successfully for detection of SN in animals, but the use of CEUS has not been reported in humans. PURPOSE: To investigate the possible use of CEUS in detecting SN in patients with malignant melanomas (MM), and to improve the method by using different concentrations of contrast agent and various positions of the extremity. MATERIAL AND METHODS: Ten patients with MM on an extremity and one healthy volunteer were included. One milliliter of a contrast agent (Sonovue; Bracco, Milan, Italy) was injected subcutaneously on both sides of the scar from the excised tumor. Contrast-enhanced lymph channels and lymph nodes (LNs) were searched for using low-mechanical-index CEUS and by stimulated acoustic emission. Afterward, lymphoscintigraphy was performed and the patient operated. During surgery, the SNs were located via scintigraphic findings, gamma-probe signals, and blue-dye visualization of lymph channels and LNs. Before the human study, a study of 10 mice was performed to exclude possible tissue damage, as the contrast agent was not registered for subcutaneous administration. RESULTS: In one patient, two contrast-enhanced inguinal LNs were visualized by CEUS, corresponding to two inguinal SNs found by scintigraphic imaging. No contrast-enhanced lymph channels or LNs were visualized in any other patients or in the volunteer. No tissue damage was observed in the 10 mice. CONCLUSION: This study does not support the use of CEUS for detection of SNs in humans. However, the application of CEUS for the investigation of SNs is still not fully explored in humans, and an alternative setup and/or contrast agent might provide better results
Udgivelsesdato: 2009/5

Originalsprog	Engelsk
Tidsskrift	Acta Radiologica
Vol/bind	50
Udgave nummer	4
Sider (fra-til)	412-417
Antal sider	5
ISSN	0284-1851
Status	Udgivet - 2009

Citationsformater

@article{5fdae7a0631c11df928f000ea68e967b,

title = "Sentinel node detection in melanomas using contrast-enhanced ultrasound",

abstract = "BACKGROUND: Sentinel node (SN) biopsy has proven to be a useful clinical method based on the combination of radionuclide tracer principles and the dye technique. Contrast-enhanced ultrasound (CEUS) has been used successfully for detection of SN in animals, but the use of CEUS has not been reported in humans. PURPOSE: To investigate the possible use of CEUS in detecting SN in patients with malignant melanomas (MM), and to improve the method by using different concentrations of contrast agent and various positions of the extremity. MATERIAL AND METHODS: Ten patients with MM on an extremity and one healthy volunteer were included. One milliliter of a contrast agent (Sonovue; Bracco, Milan, Italy) was injected subcutaneously on both sides of the scar from the excised tumor. Contrast-enhanced lymph channels and lymph nodes (LNs) were searched for using low-mechanical-index CEUS and by stimulated acoustic emission. Afterward, lymphoscintigraphy was performed and the patient operated. During surgery, the SNs were located via scintigraphic findings, gamma-probe signals, and blue-dye visualization of lymph channels and LNs. Before the human study, a study of 10 mice was performed to exclude possible tissue damage, as the contrast agent was not registered for subcutaneous administration. RESULTS: In one patient, two contrast-enhanced inguinal LNs were visualized by CEUS, corresponding to two inguinal SNs found by scintigraphic imaging. No contrast-enhanced lymph channels or LNs were visualized in any other patients or in the volunteer. No tissue damage was observed in the 10 mice. CONCLUSION: This study does not support the use of CEUS for detection of SNs in humans. However, the application of CEUS for the investigation of SNs is still not fully explored in humans, and an alternative setup and/or contrast agent might provide better results Udgivelsesdato: 2009/5",

author = "Nielsen, {K. Rue} and H. Klyver and Chakera, {A. Hougaard} and L. Nedergaard and B. Hesse and Nielsen, {M. Bachmann}",

year = "2009",

language = "English",

volume = "50",

pages = "412--417",

journal = "Acta Radiologica - Series Diagnosis",

issn = "0365-5954",

publisher = "SAGE Publications",

number = "4",

}

TY - JOUR

T1 - Sentinel node detection in melanomas using contrast-enhanced ultrasound

AU - Nielsen, K. Rue

AU - Klyver, H.

AU - Chakera, A. Hougaard

AU - Nedergaard, L.

AU - Hesse, B.

AU - Nielsen, M. Bachmann

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Sentinel node (SN) biopsy has proven to be a useful clinical method based on the combination of radionuclide tracer principles and the dye technique. Contrast-enhanced ultrasound (CEUS) has been used successfully for detection of SN in animals, but the use of CEUS has not been reported in humans. PURPOSE: To investigate the possible use of CEUS in detecting SN in patients with malignant melanomas (MM), and to improve the method by using different concentrations of contrast agent and various positions of the extremity. MATERIAL AND METHODS: Ten patients with MM on an extremity and one healthy volunteer were included. One milliliter of a contrast agent (Sonovue; Bracco, Milan, Italy) was injected subcutaneously on both sides of the scar from the excised tumor. Contrast-enhanced lymph channels and lymph nodes (LNs) were searched for using low-mechanical-index CEUS and by stimulated acoustic emission. Afterward, lymphoscintigraphy was performed and the patient operated. During surgery, the SNs were located via scintigraphic findings, gamma-probe signals, and blue-dye visualization of lymph channels and LNs. Before the human study, a study of 10 mice was performed to exclude possible tissue damage, as the contrast agent was not registered for subcutaneous administration. RESULTS: In one patient, two contrast-enhanced inguinal LNs were visualized by CEUS, corresponding to two inguinal SNs found by scintigraphic imaging. No contrast-enhanced lymph channels or LNs were visualized in any other patients or in the volunteer. No tissue damage was observed in the 10 mice. CONCLUSION: This study does not support the use of CEUS for detection of SNs in humans. However, the application of CEUS for the investigation of SNs is still not fully explored in humans, and an alternative setup and/or contrast agent might provide better results Udgivelsesdato: 2009/5

AB - BACKGROUND: Sentinel node (SN) biopsy has proven to be a useful clinical method based on the combination of radionuclide tracer principles and the dye technique. Contrast-enhanced ultrasound (CEUS) has been used successfully for detection of SN in animals, but the use of CEUS has not been reported in humans. PURPOSE: To investigate the possible use of CEUS in detecting SN in patients with malignant melanomas (MM), and to improve the method by using different concentrations of contrast agent and various positions of the extremity. MATERIAL AND METHODS: Ten patients with MM on an extremity and one healthy volunteer were included. One milliliter of a contrast agent (Sonovue; Bracco, Milan, Italy) was injected subcutaneously on both sides of the scar from the excised tumor. Contrast-enhanced lymph channels and lymph nodes (LNs) were searched for using low-mechanical-index CEUS and by stimulated acoustic emission. Afterward, lymphoscintigraphy was performed and the patient operated. During surgery, the SNs were located via scintigraphic findings, gamma-probe signals, and blue-dye visualization of lymph channels and LNs. Before the human study, a study of 10 mice was performed to exclude possible tissue damage, as the contrast agent was not registered for subcutaneous administration. RESULTS: In one patient, two contrast-enhanced inguinal LNs were visualized by CEUS, corresponding to two inguinal SNs found by scintigraphic imaging. No contrast-enhanced lymph channels or LNs were visualized in any other patients or in the volunteer. No tissue damage was observed in the 10 mice. CONCLUSION: This study does not support the use of CEUS for detection of SNs in humans. However, the application of CEUS for the investigation of SNs is still not fully explored in humans, and an alternative setup and/or contrast agent might provide better results Udgivelsesdato: 2009/5

M3 - Journal article

SN - 0365-5954

VL - 50

SP - 412

EP - 417

JO - Acta Radiologica - Series Diagnosis

JF - Acta Radiologica - Series Diagnosis

IS - 4

ER -