Lymph Node Staging

Question 1

Soultani, VRU, 2017:
CT indirect lymphography in canine mammary gland tumors

1. What had the highest sensitivity, specificity and accuracy for detection of neoplastic invasion of the sentinel lymph node?
2. What Hounsfield units value in the center of the sentinel lymph node 1min after contrast injection provided significant sensitivity, specificity and accuracy for sentinel lymph node metastasis?

Answer 1

Soultani, VRU, 2017:

1. Absence of opacification or heterogenous opacification 1min after contrast injection had the highest sensitivity, specificity and accuracy for detection of neoplastic invasion of the sentinel lymph node
2. A value of <444 Hounsfield units in the center of the sentinel lymph node 1min after contrast injection provided significant sensitivity, specificity and accuracy for sentinel lymph node metastasis

Question 2

Grimes, VRU, 2017:
Indirect CT lymphangiography for tumors of the head

1. In what % of dogs was the sentinel lymph node successfully identified within 3mins of contrast injection?
2. What delayed or prevented identification of sentinel lymph nodes in 11% of the dogs?

Answer 2

Grimes, VRU, 2017:

1. The sentinel lymph node was successfully identified within 3mins of contrast injection in 89% of the dogs
2. Compression of lymphatic vessels from ET tube ties and/or the patient’s own body weight delayed or prevented identification of sentinel lymph nodes in 11% of the dogs

Question 3

Rossi, VRU, 2018:
CT-lymphography for lymph node staging

1. What % had maximal Hounsfield units in the respective region of interests 1min after contrast injection?
2. What % of primary draining lymph nodes showed homogenous contrast enhancement following IV contrast enhancement?
3. Primary draining lymph nodes were successfully identified after local injection of contrast in what % of cases?
4. What % of primary draining lymph nodes corresponded to the anatomical lymph node(s)?
5. What % had multiple draining lymph nodes?
6. What % of cytologically positive lymph nodes were contrast enhancing on CT-lymphography?

Answer 3

Rossi, VRU, 2018:

1. 51% had maximal Hounsfield units in the respective region of interests 1min after contrast injection
2. 100% of primary draining lymph nodes showed homogenous contrast enhancement following IV contrast enhancement
3. Primary draining lymph nodes were successfully identified after local injection of contrast in 60% of cases
4. 78% of primary draining lymph nodes corresponded to the anatomical lymph node(s)
5. 27% had multiple draining lymph nodes
6. 44% of cytologically positive lymph nodes were contrast enhancing on CT-lymphography