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Aillon KL, El-Gendy N, Dennis C, Norenberg JP, McDonald J, Berkland C. Iodinated NanoClusters as an inhaled computed tomography contrast agent for lung visualization. Mol Pharm 2010; 7:1274-82. [PMID: 20575527 DOI: 10.1021/mp1000718] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Improvements to contrast media formulations may be an effective way to increase the accuracy and effectiveness of thoracic computed tomography (CT) imaging in disease evaluation. To achieve contrast enhancement in the lungs, a relatively large localized concentration of contrast media must be delivered. Inhalation offers a noninvasive alternative to intrapleural injections for local lung delivery, but effective aerosolization may deter successful imaging strategies. Here, NanoCluster technology was applied to N1177, a diatrizoic acid derivative, to formulate low density nanoparticle agglomerates with aerodynamic diameters <or=5 microm. Excipient-free N1177 NanoCluster powders were delivered to rats by insufflation or inhalation and scanned using CT up to 1 h post dose. CT images after inhalation showed a approximately 120 (HU) Hounsfield units contrast increase in the lungs, which was more than sufficient contrast for thoracic CT imaging. Lung tissue histology demonstrated that N1177 NanoClusters did not damage the lungs. NanoCluster particle engineering technology offers a novel approach to safely and efficiently disseminate high concentrations of contrast agents to the lung periphery.
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Affiliation(s)
- Kristin L Aillon
- Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas 66047, USA
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2
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Boote E, Fent G, Kattumuri V, Casteel S, Katti K, Chanda N, Kannan R, Katti K, Churchill R. Gold nanoparticle contrast in a phantom and juvenile swine: models for molecular imaging of human organs using x-ray computed tomography. Acad Radiol 2010; 17:410-7. [PMID: 20207313 DOI: 10.1016/j.acra.2010.01.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 01/22/2010] [Accepted: 01/25/2010] [Indexed: 01/01/2023]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to demonstrate the application of gold nanoparticles (AuNP) as a contrast agent for a clinical x-ray computed tomography (CT) system using a phantom and juvenile swine. MATERIALS AND METHODS A tissue-mimicking phantom with spherical inclusions containing known concentrations of Au was scanned. Swine were injected with gum Arabic stabilized Au nanoparticles (GA-AuNP), up to 85 mg kg(-1) body weight. CT scans were performed before and after the injections. Changes in Hounsfield unit (HU) values between pre- and post- injection scans were evaluated and compared to postmortem determinations of Au uptake. Average uptake of GA-AuNP in the liver of the swine was 380 microg per gram of liver and 680 microg per gram of spleen. RESULTS Concentrations of Au in tissues increased the CT numbers in liver by approximately 22 HU per mg Au concentration at 80 kVp and 27 HU per mg Au concentration at 140 kVp. These data were consistent with HU changes observed for similar concentrations in the phantom. CONCLUSIONS AuNP-based contrast agents may be useful in x-ray based CT. This study provides data for determining concentrations of AuNP in comparison to other contrast materials.
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El-Gendy N, Aillon KL, Berkland C. Dry powdered aerosols of diatrizoic acid nanoparticle agglomerates as a lung contrast agent. Int J Pharm 2010; 391:305-12. [PMID: 20214960 DOI: 10.1016/j.ijpharm.2010.03.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Revised: 02/23/2010] [Accepted: 03/01/2010] [Indexed: 11/25/2022]
Abstract
Aerosolized contrast agents may improve the resolution of biomedical imaging modalities and enable more accurate diagnosis of lung diseases. Many iodinated compounds, such as diatrizoic acid, have been shown to be safe and useful for radiographic examination of the airways. Formulations of such compounds must be improved in order to allow imaging of the smallest airways. Here, diatrizoic acid nanoparticle agglomerates were created by assembling nanoparticles into inhalable microparticles that may augment deposition in the lung periphery. Nanoparticle agglomerates were fully characterized and safety was determined in vivo. After dry powder insufflation to rats, no acute alveolar tissue damage was observed 2h post-dose. Diatrizoic acid nanoparticle agglomerates possess the characteristics of an efficient and safe inhalable lung contrast agent.
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Affiliation(s)
- Nashwa El-Gendy
- Department of Pharmaceutical Chemistry, The University of Kansas, Lawrence, KS 66047, United States
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4
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Preliminary study of indirect CT lymphography-guided sentinel lymph node biopsy in a tongue VX2 carcinoma model. Int J Oral Maxillofac Surg 2009; 38:1268-72. [DOI: 10.1016/j.ijom.2009.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2008] [Revised: 04/24/2009] [Accepted: 07/13/2009] [Indexed: 11/21/2022]
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Cai W, Chen X. Nanoplatforms for targeted molecular imaging in living subjects. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2007; 3:1840-54. [PMID: 17943716 DOI: 10.1002/smll.200700351] [Citation(s) in RCA: 351] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Molecular or personalized medicine is the future of patient management and molecular imaging plays a key role towards this goal. Recently, nanoplatform-based molecular imaging has emerged as an interdisciplinary field, which involves chemistry, engineering, biology, and medicine. Possessing unprecedented potential for early detection, accurate diagnosis, and personalized treatment of diseases, nanoplatforms have been employed in every single biomedical imaging modality, namely, optical imaging, computed tomography, ultrasound, magnetic resonance imaging, single-photon-emission computed tomography, and positron emission tomography. Multifunctionality is the key advantage of nanoplatforms over traditional approaches. Targeting ligands, imaging labels, therapeutic drugs, and many other agents can all be integrated into the nanoplatform to allow for targeted molecular imaging and molecular therapy by encompassing many biological and biophysical barriers. In this Review, we will summarize the current state-of-the-art of nanoplatforms for targeted molecular imaging in living subjects.
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Affiliation(s)
- Weibo Cai
- Molecular Imaging Program at Stanford (MIPS), Department of Radiology and Bio-X Program, Stanford University, Stanford, CA 94305, USA
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6
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Hyafil F, Cornily JC, Feig JE, Gordon R, Vucic E, Amirbekian V, Fisher EA, Fuster V, Feldman LJ, Fayad ZA. Noninvasive detection of macrophages using a nanoparticulate contrast agent for computed tomography. Nat Med 2007; 13:636-41. [PMID: 17417649 DOI: 10.1038/nm1571] [Citation(s) in RCA: 328] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2006] [Accepted: 11/14/2006] [Indexed: 01/01/2023]
Abstract
Sudden fibrous cap disruption of 'high-risk' atherosclerotic plaques can trigger the formation of an occlusive thrombus in coronary arteries, causing acute coronary syndromes. High-risk atherosclerotic plaques are characterized by their specific cellular and biological content (in particular, a high density of macrophages), rather than by their impact on the vessel lumen. Early identification of high-risk plaques may be useful for preventing ischemic events. One major hurdle in detecting high-risk atherosclerotic plaques in coronary arteries is the lack of an imaging modality that allows for the identification of atherosclerotic plaque composition with high spatial and temporal resolutions. Here we show that macrophages in atherosclerotic plaques of rabbits can be detected with a clinical X-ray computed tomography (CT) scanner after the intravenous injection of a contrast agent formed of iodinated nanoparticles dispersed with surfactant. This contrast agent may become an important adjunct to the clinical evaluation of coronary arteries with CT.
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Affiliation(s)
- Fabien Hyafil
- Sinai Translational and Molecular Imaging Institute and Imaging Science Laboratories, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York, New York 10029, USA
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7
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Cuenca AG, Jiang H, Hochwald SN, Delano M, Cance WG, Grobmyer SR. Emerging implications of nanotechnology on cancer diagnostics and therapeutics. Cancer 2006; 107:459-66. [PMID: 16795065 DOI: 10.1002/cncr.22035] [Citation(s) in RCA: 268] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Nanotechnology is multidisciplinary field that involves the design and engineering of objects <500 nanometers (nm) in size. The National Cancer Institute has recognized that nanotechnology offers an extraordinary, paradigm-changing opportunity to make significant advances in cancer diagnosis and treatment. In the last several decades, nanotechnology has been studied and developed primarily for use in novel drug-delivery systems (e.g. liposomes, gelatin nanoparticles, micelles). A recent explosion in engineering and technology has led to 1) the development of many new nanoscale platforms, including quantum dots, nanoshells, gold nanoparticles, paramagnetic nanoparticles, and carbon nanotubes, and 2) improvements in traditional, lipid-based nanoscale platforms. The emerging implications of these platforms for advances in cancer diagnostics and therapeutics form the basis of this review. A widespread understanding of these new technologies is important, because they currently are being integrated into the clinical practice of oncology.
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Affiliation(s)
- Alex G Cuenca
- Division of Surgical Oncology, Department of Surgery, University of Florida, Gainesville, Florida 32610, USA
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Hayashi H, Tangoku A, Suga K, Shimizu K, Ueda K, Yoshino S, Abe T, Sato T, Matsunaga N, Oka M. CT lymphography-navigated sentinel lymph node biopsy in patients with superficial esophageal cancer. Surgery 2006; 139:224-35. [PMID: 16455332 DOI: 10.1016/j.surg.2005.07.027] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2005] [Revised: 07/21/2005] [Accepted: 07/23/2005] [Indexed: 01/02/2023]
Abstract
BACKGROUND To evaluate experimentally and clinically the feasibility of a newly developed technique of endoscopic computed tomography (CT) lymphography with endoscopic submucosal injection of iopamidol for esophageal sentinel lymph node (SLN) mapping and biopsy examination. METHODS Nine anesthetized dogs underwent CT after endoscopic submucosal injection of 2 mL iopamidol; 1.25-mm thick CT images were obtained before and at 1, 3, 5, 7, and 10 minutes after contrast injection. Clinically, 12 patients with superficial esophageal cancer (preoperative imaging stage: cT1, cN0) underwent CT lymphography in a similar fashion at 1, 5, and 10 minutes after peritumoral injection, followed by radical esophagectomy and regional lymph node dissection under CT lymphography guidance. RESULTS CT lymphography visualized the draining lymphatic vessels and SLNs within 5 minutes after contrast injection. All 14 SLNs in dogs (average, 1.5 nodes per animal; range, 1-2) and 28 SLNs in patients (average, 2.3 nodes per patient; range, 1-4) were found intraoperatively at the correct location under CT lymphography guidance. Lymph node metastasis could be detected with excellent sensitivity and accuracy in this small number of patients with no false-negative findings; metastasis was positive only in the preoperatively identified SLNs in 4 patients and in both SLNs and distant nodes in 1 patient, and was negative in all resected nodes in the remaining 7 patients. CONCLUSIONS Endoscopic CT lymphography appears to allow accurate identification of direction and locations of lymph flow and SLNs, and has the potential clinical applicability for esophageal SLN mapping and biopsy examination, but will require a large study to determine its accuracy and usefulness.
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Affiliation(s)
- Hideto Hayashi
- Department of Surgery II, Yamaguchi University School of Medicine, Japan
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Suga K, Shimizu K, Kawakami Y, Tangoku A, Zaki M, Matsunaga N, Oka M. Lymphatic drainage from esophagogastric tract: feasibility of endoscopic CT lymphography for direct visualization of pathways. Radiology 2006; 237:952-60. [PMID: 16304114 DOI: 10.1148/radiol.2373041578] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the feasibility of an endoscopic computed tomographic (CT) lymphography technique with submucosal injection of iopamidol for direct visualization of lymphatic drainage pathways in dogs and in patients with operable esophageal cancer. MATERIALS AND METHODS With institutional animal committee approval, a total of 2 mL of undiluted iopamidol was injected into the esophageal (n = 6) or gastric (n = 3) submucosa in nine dogs by using a flexible endoscope. Multi-detector row CT images (section thickness, 1.25 mm) were obtained before contrast material injection and during the 10 minutes after injection. The animals were euthanized so that their lymphatic anatomy could be examined. With ethical committee approval and patient informed consent, nine patients with esophageal cancer also underwent CT lymphography with peritumoral injection of 2 mL of iopamidol, followed by esophagectomy and regional lymph node dissection with CT lymphographic guidance. The histopathologic features of dissected nodes, including sentinel lymph nodes (SLNs), were examined. RESULTS CT lymphography depicted the direct connection of lymphatic drainage vessels with enhanced and/or unenhanced nodes (ie, SLNs) as early as within 5 minutes after contrast material injection in all subjects. All 13 SLNs in dogs (1.4 nodes per animal) and 18 SLNs in patients (two nodes per patient) were found and dissected at the correct location by using CT lymphographic guidance. In patients, histopathologic examination revealed the high predictive value of CT lymphographic-guided SLN biopsy: Only one of the preoperatively identified SLNs in three patients and both SLNs and adjacent nodes in two patients were positive for metastasis; all resected nodes in the remaining four patients were negative. CONCLUSION Endoscopic CT lymphography is a feasible method for visualizing the direct connection between and the accurate anatomic location of SLNs and lymphatic drainage vessels.
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Affiliation(s)
- Kazuyoshi Suga
- Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
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Suga K, Yuan Y, Ueda K, Kaneda Y, Kawakami Y, Zaki M, Matsunaga N. Computed Tomography Lymphography With Intrapulmonary Injection of Iopamidol for Sentinel Lymph Node Localization. Invest Radiol 2004; 39:313-24. [PMID: 15167097 DOI: 10.1097/01.rli.0000124288.70621.41] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Experimental and clinical evaluation of the potential utility of indirect computed tomographic lymphography (CT-LG) with intrapulmonary injection of iopamidol for preoperative localization of sentinel lymph node station in non-small cell lung cancer. METHODS CT-LG with intrapulmonary injection of 0.5 mL of undiluted iopamidol was performed in 10 dogs using a multidetector-row CT unit, followed by postmortem examination of enhanced lymph nodes in 5 of these dogs. The CT-LG with peritumoral injection of 1 mL of the contrast agent was also performed in 9 patients with non-small cell lung cancer without lymphadenopathy. At surgery, enhanced lymph nodes were resected under CT-LG guide, followed by standard lymph node dissection with macroscopic and histologic examination. A significant enhancement of lymph nodes was determined when CT attenuation value was increased with 30 Hounsfield units (HU) compared with precontrast images. RESULTS CT-LG visualized a total of 15 enhanced lymph nodes (on average, 1.5 nodes per animal) within 2 minutes after contrast injection in the 10 dogs, with average size of 6.7+/- 1.9 mm and average maximum CT attenuation of 149 +/- 41 HU. All the 8 enhanced nodes in 5 dogs were found in the appropriate anatomic locations in postmortem examinations. Without noticeable complications, CT-LG visualized 30 ipsilateral intrathoracic lymph nodes including 19 hilar/pulmonary and 11 mediastinal nodes in the 9 patients (on average, 2.2 hilar/pulmonary and 1.1 mediastinal nodes per patient) within 2 minutes after contrast injection, with average size of 4.7+/- 0.4 mm and average maximum CT attenuation of 134 +/- 52 HU. At surgery, all these enhanced nodes could be accurately found and resected under CT-LG guidance. Metastasis was not evident in either of these enhanced lymph nodes or the remaining distant nodes in all patients. CONCLUSION Quick and accurate localization of sentinel lymph node station on detailed underlying lung anatomy by using indirect CT-LG may be of value to guide selective lymph node dissection for minimally invasive surgery in non-small cell lung cancer.
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Affiliation(s)
- Kazuyoshi Suga
- Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
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Suga K, Yuan Y, Okada M, Matsunaga N, Tangoku A, Yamamoto S, Oka M. Breast sentinel lymph node mapping at CT lymphography with iopamidol: preliminary experience. Radiology 2003; 230:543-52. [PMID: 14699178 DOI: 10.1148/radiol.2302021380] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate sentinel lymph node (SLN) mapping with interstitial computed tomographic (CT) lymphography with small volumes of iopamidol for direction of SLN biopsy in breast cancer. MATERIALS AND METHODS Thin-section transverse and three-dimensional CT images that included the breast and axilla were acquired at multi-detector row helical CT in 17 patients with operable breast cancer before subcutaneous injection of 2 mL of undiluted iopamidol into peritumoral and periareolar areas and 1-5 minutes after massage of injection sites. Location and size of SLNs were assessed at CT lymphography and were compared with SLNs at standard axillary lymph node dissection with blue dye staining. RESULTS CT lymphography allowed localization of SLNs in all patients by means of visualization of a direct connection between an SLN and its afferent lymphatic vessels draining from the injection sites. Afferent vessels were joined and drained into a single axillary SLN, except in four patients with two or three SLNs, including a parasternal one. SLNs did not enhance because of rerouting of lymph flow in four patients. At surgery, SLNs that were stained or not stained with blue dye were easily found with CT lymphographic guidance. Tumoral infiltration was not evident in any resected nodes, except for infiltration in one patient with micrometastasis in SLN alone and infiltration in four patients with massive metastasis in both SLN and distant nodes. CONCLUSION Because preoperative CT lymphography-guided SLN mapping provides SLN position with detailed lymphatic anatomy, it may be useful for the direction of breast SLN biopsy.
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Affiliation(s)
- Kazuyoshi Suga
- Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan.
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Suga K, Yuan Y, Nobuhiko O, Okada M, Kawakami Y, Matsunaga N. Potential of Magnetic Resonance Lymphography With Intrapulmonary Injection of Gadopentetate Dimeglumine for Visualization of the Pulmonary Lymphatic Basin in Dogs. Invest Radiol 2003; 38:679-89. [PMID: 14566177 DOI: 10.1097/01.rli.0000085306.65588.8e] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate a new approach of magnetic resonance (MR) lymphography with intraalveolar injection of a conventional extracellular contrast agent (gadopentetate dimeglumine) for imaging lymphatic basin draining from specific portions of the lung. METHODS Three-dimensional T1-weighted spoiled gradient-recalled echo MR sequence images were acquired serially before and for 40 minutes after intraalveolar injection of gadopentetate dimeglumine in a total of 14 anesthetized beagle dogs. Six of these dogs received 1 mL undiluted and low-concentration (75%) contrast agent into the same portion of the right caudal lobe during a 7-day interval. In all dogs, including these 6 dogs, MR lymphography was repeated with injection of the low-concentration contrast agent into different lung regions at 7-day intervals to evaluate the differences of the visualized draining lymphatic station. Lymphatic enhancement was quantified by percent increases of signal intensity against precontrast. Postmortem examination of the lymphatic anatomy was performed in 7 of these animals. RESULTS In all dogs, the lymphatic station draining from the injection sites was visualized within 5 minutes after contrast injection. The maximum percent increase of signal intensity of the same middle tracheobronchial lymph nodes was significantly greater with a low-concentration (75%) contrast agent than with an undiluted one in the same 6 dogs (n = 6, 247.6 +/- 30.5% vs. 204.2 +/- 33.8%; P < 0.01). Different lymphatic stations draining from the different injection sites were visualized in all dogs. In a total of 12 MR studies that showed extended nodal enhancement after injection of the low-concentration contrast agent, the enhancement peak of the most proximal nodes (n = 12) from the injection sites appeared earlier than that of their distant nodes (n = 12), with a maximum percent increase of signal intensity of 249.8 +/- 42.4%. The visualized lymph nodes were found in the appropriate locations postmortem, with significant correlation for nodal sizes (r = 0.965; P < 0.0001). CONCLUSION MR lymphography with low-concentration gadopentetate dimeglumine can quickly and sufficiently visualize the drainage lymphatic station from specific lung portions, and may have the potential of sentinel node mapping in lung cancer.
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Affiliation(s)
- Kazuyoshi Suga
- Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan
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Suga K, Ogasawara N, Okada M, Matsunaga N. Interstitial CT lymphography-guided localization of breast sentinel lymph node: preliminary results. Surgery 2003; 133:170-9. [PMID: 12605178 DOI: 10.1067/msy.2003.17] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Accurate localization of the breast sentinel lymph node (SLN) can be challenging as a minimally invasive approach to the treatment of early-stage breast cancer. We tested the potential capability of interstitial computed tomographic lymphography (CT-LG) using a conventional contrast agent (iopamidol) for SLN mapping. METHODS In 14 female dogs, 0.5 and 1 mL of undiluted iopamidol was injected subcutaneously into the 2 skin areas overlying the mammary gland. Contiguous, 2 mm-thick multidetector helical CT images were obtained through the upper breast and axilla before, and for 60 minutes after, gentle massage at the injection site. Three-dimensional (3D) CT images were obtained from the postcontrast images showing the greatest SLN enhancement. This CT-LG with 2 mL of iopamidol was also evaluated in 5 human female volunteers. RESULTS The direct connection of SLN and lymphatic vessels draining from the injection sites in the animal models was clearly visualized, even with 0.5 mL of iopamidol. With this dose, the SLN attenuation was maximally enhanced, with a mean of 274 Hounsfield units (HU) on the first postcontrast images. The topographic 3D images provided the comprehensive anatomy of these lymphatic pathways. Of the 28 SLNs and 184 distant nodes visualized on CT images, all of the SLNs (100%) and 161 (87.5%) of the distant nodes could be resected at premortem and/or postmortem, with a good correlation in the locations and sizes with those on the CT images. The CT-LG effectively localized 5 SLNs with averaged maximum attenuation of 223 HU in the human volunteers, without any significant adverse effects. CONCLUSION Interstitial CT-LG using small volumes of iopamidol can sufficiently visualize breast lymphatic drainage and may have potential utility for breast SLN mapping.
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Affiliation(s)
- Kazuyoshi Suga
- Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505, Japan
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Suga K, Ogasawara N, Yuan Y, Okada M, Matsunaga N, Tangoku A. Visualization of breast lymphatic pathways with an indirect computed tomography lymphography using a nonionic monometric contrast medium iopamidol: preliminary results. Invest Radiol 2003; 38:73-84. [PMID: 12544070 DOI: 10.1097/00004424-200302000-00002] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES The capability of an indirect computed tomographic lymphography (CT-LG) using a nonionic monometric contrast medium iopamidol for visualizing breast lymphatic pathways was preliminarily tested. MATERIALS AND METHODS In 10 female dogs, a total of 0.5 and 1 mL of undiluted iopamidol was injected subcutaneously into the skin areas overlying the both caudal mammary glands. Contiguous 2-mm-thick multidetector raw helical CT images were obtained through the upper thorax and axilla before and during 60 minutes after gentle massage at the injection sites, with reconstruction into three-dimensional (3D) postcontrast CT images. The first lymph node (1st LN) directly draining from the injection sites was marked under CT guidance, followed by pre- and postmortem examinations. This CT-LG with 2-mL iopamidol was also attempted in five human female volunteers. RESULTS Even with 0.5-mL iopamidol, the CT-LG clearly visualized the direct connection of the 1st LN and lymphatic vessels draining from the injection sites throughout the examination time in all the animals, with the maximum CT attenuation of 269 Hounsfield units (HU) +/- 137 in the 1st LN on the first postcontrast images. The topographic 3D images provided comprehensive anatomic outlines of these lymphatic pathways. Of the total of 20 opacified 1st LN and 110 distant nodes, all the 1st LN (100%) and 92 (83.6%) distant nodes could be resected at pre- or postmortem, with a good correlation with the CT images. The CT-LG also effectively localized the 1st LN with the maximum attenuation of 223 HU +/- 63 in the human volunteers, without any significant late adverse effects. CONCLUSION Indirect CT-LG with iopamidol may have excellent potential for visualizing breast lymphatic drainage and for preoperative localization of breast sentinel lymph nodes.
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Affiliation(s)
- KazuyoshiI Suga
- Department of Radiology, Yamaguchi University School of Medicine, Ube, Japan.
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Cook BE, Lucarelli MJ, Lemke BN, Dortzbach RK, Kaufman PL, Forrest L, Greene E, Gabelt BT. Eyelid lymphatics II: a search for drainage patterns in the monkey and correlations with human lymphatics. Ophthalmic Plast Reconstr Surg 2002; 18:99-106. [PMID: 11897950 DOI: 10.1097/00002341-200203000-00003] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To study the lymphatic drainage of the cynomolgus monkey through the use of lymphoscintigraphy. METHODS Lymphoscintigraphy with 500 microCi of 99mTechnetium sulfur colloid injected at specific sites around the eyelids was performed with five cynomolgus monkeys in lateral and ventral positions. RESULTS Lymphoscintigraphy of the monkey eyelid and periocular tissue revealed lymphatic drainage to the parotid lymph nodes from the entire upper eyelid, medial canthus, and lateral lower eyelid and drainage to the submandibular lymph nodes from the medial and central lower eyelid. In addition to draining to the parotid lymph nodes, the central upper eyelid was also seen to drain to the submandibular lymph nodes. CONCLUSIONS Lymphoscintigraphy of the cynomolgus monkey eyelids reveals discrete lymphatic drainage pathways for the upper and lower eyelids and a dual pathway for the central upper eyelid. Future studies will help to clarify the lymphatic drainage pathways of human eyelids.
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Affiliation(s)
- Briggs E Cook
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Wisconsin, USA.
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Ketai LH, Muggenberg BA, McIntire GL, Bacon ER, Rosenberg R, Losco PE, Toner JL, Nikula KJ, Haley P. CT imaging of intrathoracic lymph nodes in dogs with bronchoscopically administered iodinated nanoparticles. Acad Radiol 1999; 6:49-54. [PMID: 9891152 DOI: 10.1016/s1076-6332(99)80061-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of the study was to determine if airway instillation of iodinated nanoparticles results in contrast material enhancement of tracheobronchial lymph nodes in dogs. MATERIALS AND METHODS Eight dogs underwent intrabronchial instillation of iodinated nanoparticles; six dogs received 900 mg each, and two dogs received 450 mg each. Spiral computed tomography (CT) was then performed 2-34 days later. RESULTS CT scans obtained 2 days after instillation showed the presence of contrast material within the lung parenchyma but no nodal enhancement. Scans obtained 6-34 days after instillation showed enhancement of the right, left, and middle tracheobronchial lymph nodes (analogous to the mediastinal nodes in humans). Mean nodal attenuation on CT images was 117 HU +/- 43, and the mean nodal volume was 129 mm3 +/- 113. Histologic specimens of the nodes showed macrophage hyperplasia. CONCLUSION Iodinated nanoparticles instilled into small airways are transported to the tracheobronchial lymph nodes, where they result in contrast enhancement.
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Affiliation(s)
- L H Ketai
- Department of Radiology, University of New Mexico Health Sciences Center, Albuquerque 87131, USA
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Wolf GL, Shore MT, Bessin G, McIntire GL, Bacon ER, Illig KJ. Lymph node extraction of radiopaque nanoparticulates in the rabbit as measured in vivo with CT. Acad Radiol 1999; 6:55-60. [PMID: 9891153 DOI: 10.1016/s1076-6332(99)80062-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
RATIONALE AND OBJECTIVES The purpose of this study was to estimate in vivo extraction of lymphographic material in the popliteal node of the rabbit. MATERIALS AND METHODS Serial quantitative computed tomography (CT) of target tissues in four legs of two rabbits was performed after subcutaneous injection of an improved lymphographic contrast agent. Massage was used as a lymphotrophic intervention. RESULTS At 15 minutes, the mean change in Hounsfield units measured 815 in the popliteal node, 219 in afferent lymphatic vessels, and 127 in efferent lymphatic vessels. The nodal extraction of nanoparticulates from the lymph was approximately 55%. Nodal massage allowed the amount of nanoparticulate remaining in sinusoidal lymph to be estimated. CONCLUSION Functional CT performed with timed studies, proper radiopaque materials, and physiologic interventions can depict in vivo lymphatic physiology under minimally invasive conditions.
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Affiliation(s)
- G L Wolf
- Department of Radiology, Massachusetts General Hospital, Boston, USA
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McIntire GL, Bacon ER, Toner JL, Cornacoff JB, Losco PE, Illig KJ, Nikula KJ, Muggenburg BA, Ketai L. Pulmonary delivery of nanoparticles of insoluble, iodinated CT X-ray contrast agents to lung draining lymph nodes in dogs. J Pharm Sci 1998; 87:1466-70. [PMID: 9811507 DOI: 10.1021/js980060r] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Lung cancer continues to be a leading cause of death around the world. Staging of this disease is critically dependent upon the involvement or noninvolvement of the lymph nodes which drain the region of lung containing the lesion/tumor. Palpation, unenhanced CT, and lymph node excision (i.e., mediastinectomy) are currently used to ascertain the status of these regional draining lymph nodes. The work reported herein details the first efforts toward the pulmonary instillation of iodinated nanoparticles for contrast-enhanced CT of lung draining lymph nodes. The data reflect the impact of dose, time post instillation, and formulation (surfactant) upon the observed CT enhancement of the tracheobronchial lymph nodes of beagle dogs. In addition, initial safety is discussed with both macroscopic and microscopic observations. The results indicate that pulmonary instillation of small volumes of iodinated nanoparticles could be successfully used to aid staging of lung cancer by CT imaging.
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Affiliation(s)
- G L McIntire
- Nycomed, 466 Devon Park Drive, P.O. Box 6630, Wayne, Pennsylvania 19087-8630, USA.
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Wisner ER, Katzberg RW, Griffey SM, Haley PJ, Johnson DK, Vessey AR. Characterization of normal and cancerous lymph nodes on indirect computed tomography lymphographic studies after interstitial injection of iodinated nanoparticles. Acad Radiol 1996; 3 Suppl 2:S257-60. [PMID: 8796576 DOI: 10.1016/s1076-6332(96)80551-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- E R Wisner
- Department of Radiology, University of California Davis Medical Center, Sacramento 95817, USA
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Wisner ER, Katzberg RW, Link DP, Griffey SM, Drake CM, Vessey AR, Johnson D, Haley PJ. Indirect computed tomography lymphography using iodinated nanoparticles to detect cancerous lymph nodes in a cutaneous melanoma model. Acad Radiol 1996; 3:40-8. [PMID: 8796639 DOI: 10.1016/s1076-6332(96)80331-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate differences in contrast uptake in normal and cancerous lymph nodes on indirect computed tomography (CT) in swine, we conducted lymphographic examinations after subcutaneous injection of a lymphotropic iodinated nanoparticle suspension. METHODS Perilesional subcutaneous contrast injections (2 ml per lesion) of a 15% wt/vol iodinated nanoparticle suspension were made in immature Sinclair miniature swine (n = 5) with cutaneous melanomas. Average attenuation, iodine concentration, node volume, and total iodine uptake were estimated on the CT scans for each opacified lymph node 24 hr after injection. Nodes were classified as normal or cancerous microscopically, and the percentage of tumor replacement was estimated in cancerous nodes. RESULTS Average attenuation and iodine concentration were higher in normal nodes, and total iodine uptake was higher in cancerous nodes with greater than 25% replacement (p < .05). Architectural alterations in opacified cancerous nodes included medullary filling defects, expansile cortical lesions, and disruption of corticomedullary junctions. CONCLUSION Quantitative and qualitative differences in iodinated nanoparticle enhancement characteristics are useful in distinguishing between normal and cancerous lymph nodes on indirect CT lymphography examinations.
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Affiliation(s)
- E R Wisner
- Department of Radiology, University of California Davis Medical Center, Sacramento, USA
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Wisner ER, Katzberg RW, Griffey SM, Drake CM, Haley PJ, Vessey AR. Indirect computed tomography lymphography using iodinated nanoparticles: time and dose response in normal canine lymph nodes. Acad Radiol 1995; 2:985-93. [PMID: 9419671 DOI: 10.1016/s1076-6332(05)80701-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
RATIONALE AND OBJECTIVES We evaluated the effect of time and dose on lymph node iodine uptake after subcutaneous or submucosal administration of iodinated nanoparticles used for computed tomography lymphography. METHODS We injected 0.1-6 ml of a 15% wt/vol iodinated nanoparticle suspension into the distal extremities subcutaneously (n = 5) or into the buccal submucosa (n = 7) of normal dogs. Precontrast and 4, 12, 24, and 48 hr after contrast administration, CT scans of opacified lymph nodes were obtained. Iodine concentration, node volume, and total iodine uptake were estimated for each node. RESULTS All estimated parameters increased between 4 and 12 hr postcontrast (p < .05), with no significant increase thereafter. At 24 hr postcontrast, iodine concentration ranged from 0.01 to 16.1 mg/ml (47-568 Hounsfield units). The average iodine concentration and total iodine uptake increased with contrast dose (p < .05) for all lymph node groups evaluated. Node opacification also revealed internal architectural detail. CONCLUSION Subcutaneous and submucosal injections of iodinated nanoparticles result in a dose-dependent iodine uptake in targeted lymph nodes. In addition, architectural detail within opacified nodes can be visualized.
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Affiliation(s)
- E R Wisner
- Department of Radiology, University of California, Davis Medical Center, Sacramento, USA
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Wisner ER, Katzberg RW, Koblik PD, McGahan JP, Griffey SM, Drake CM, Harnish PP, Vessey AR, Haley PJ. Indirect computed tomography lymphography of subdiaphragmatic lymph nodes using iodinated nanoparticles in normal dogs. Acad Radiol 1995; 2:405-12. [PMID: 9419583 DOI: 10.1016/s1076-6332(05)80343-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
RATIONALE AND OBJECTIVES We evaluated the imaging characteristics of an iodinated particulate contrast agent for indirect computed tomography (CT) lymphography of normal subdiaphragmatic lymph nodes in dogs. METHODS Four milliliters of a 15% (wt/vol) iodinated nanoparticle suspension was injected into the gastric, colonic, rectal, or cervical submucosa, loose paraprostatic fascia, or metatarsal subcutaneous tissues in 10 healthy beagles. Endoscopic, CT, or ultrasound guidance was used when necessary to facilitate contrast agent delivery. CT and radiographic images were obtained prior to contrast administration and at 4 hr, 24 hr, and 7 days postcontrast injection. Postmortem examinations were then conducted. RESULTS CT images showed enhancement of regional lymph nodes draining the various injection sites. The mean attenuation of opacified nodes was 678 +/- 463 Hounsfield units 24 hr after injection and remained elevated 7 days later. Lymph node opacification on CT images correlated well with the node location observed on postmortem examinations. CONCLUSION Subdiaphragmatic lymph nodes can be effectively opacified using an iodinated nanoparticle contrast agent for indirect CT lymphography.
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Affiliation(s)
- E R Wisner
- Department of Radiology, University of California Davis Medical Center, Sacramento 95817, USA
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