The Experts below are selected from a list of 228 Experts worldwide ranked by ideXlab platform
Jeet Minocha - One of the best experts on this subject based on the ideXlab platform.
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cerebral embolization of ethiodized oil following intranodal Lymphangiography
Seminars in Interventional Radiology, 2015Co-Authors: Arman Sheybani, Ron C Gaba, Jeet MinochaAbstract:Intranodal Lymphangiography (IL) has supplanted pedal Lymphangiography (PL) as an easier and more practical approach to opacifying lymphatic vessels for interventional radiologists treating refractory chyle leaks. As more interventional radiologists—many of who are not trained in or have not performed PL—incorporate IL into their practice, it is imperative that they be familiar with the risks of Lymphangiography, including pulmonary and systemic embolization of oily contrast material. Herein, the authors report a devastating case of cerebral embolization of ethiodized oil following IL and review the literature regarding systemic embolization following Lymphangiography.
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ultrasound guided intranodal Lymphangiography followed by thoracic duct embolization for treatment of postoperative bilateral chylothorax
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2014Co-Authors: Ahmad Parvinian, Girish C Mohan, Ron C Gaba, D F Saldanha, Grace M Knuttinen, Jeet MinochaAbstract:Background Percutaneous thoracic duct embolization (TDE) is a safe, effective, and minimally invasive option for treating chylothorax. A recent report demonstrated the feasibility of ultrasound-guided intranodal Lymphangiography as an alternative to pedal Lymphangiography for visualization of the thoracic duct, promising relative technical ease and decreased procedure time for TDE. Methods We report a case of postoperative bilateral chylothorax treated with ultrasound-guided intranodal Lymphangiography followed by TDE. Results Intranodal Lymphangiography resulted in rapid opacification of the abdominal lymphatics, permitting technically successful primary and secondary embolization procedures. Deployment of metallic coils and liquid embolic agents within the thoracic duct produced rapid clinical and radiographic improvement. Conclusion Intranodal Lymphangiography is a reliable, reproducible, and less technically challenging alternative to pedal Lymphangiography. © 2013 Wiley Periodicals, Inc. Head Neck 36: E21–E24, 2014
Maxim Itkin - One of the best experts on this subject based on the ideXlab platform.
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Lymphangiography and lymphatic embolization for the treatment of refractory chylous ascites
CardioVascular and Interventional Radiology, 2018Co-Authors: G Nadolski, Nikunj Rashmikant Chauhan, Maxim ItkinAbstract:Purpose Assess the effectiveness of conventional Lymphangiography, MR Lymphangiography, and lymphatic embolization for the diagnosis and treatment of refractory chylous ascites.
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Modern Techniques of Lymphangiography and Interventions: Current Status and Future Development
CardioVascular and Interventional Radiology, 2018Co-Authors: Maxim Itkin, Gregory J. NadolskiAbstract:One of the crucial functions of the lymphatic system is maintenance of fluid balance. Nonetheless, due to lack of clinical imaging and interventional techniques, the lymphatic system has been under the radar of the medical community. The recently developed intranodal Lymphangiography and dynamic contrast-enhanced MR Lymphangiography provide new insight into lymphatic pathology. Thoracic duct embolization has become the method of choice for the treatment of patients with chylous leaks. Interstitial lymphatic embolization further expanded the lymphatic embolization approaches. Liver lymphatic Lymphangiography and embolization allow treatment of postsurgical liver lymphorrhea and protein-losing enteropathy. The potential for further growth of lymphatic interventions is vast and includes liver lymphatic procedures and advanced thoracic duct interventions, such as thoracic duct externalization and stenting. These current and future advances will open up a realm of new treatments and diagnostic opportunities.
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MR Lymphangiography in Children: Technique and Potential Applications.
Radiographics, 2017Co-Authors: Govind B. Chavhan, Joao G. Amaral, Michael Temple, Maxim ItkinAbstract:The lymphatic system, an important component of the circulatory system with essential physiologic functions, can be affected by various disease processes. There has been a delay in the development of effective imaging methods for the lymphatic system due to its small size, which limits visualization as well as introduction of contrast material. Traditionally, the lymphatic system has been imaged by injecting contrast material or radiotracers into the feet or hands. This is not sufficient for assessment of the central conducting lymphatics (CCLs) (such as the thoracic duct or the cisterna chyli). Fluoroscopic intranodal Lymphangiography with injection of oil-based contrast material into groin lymph nodes improves visualization of CCLs but is limited in practice owing to the use of radiation and the potential risk for paradoxical embolization in children with left-to-right shunt. Dynamic contrast material-enhanced (DCE) magnetic resonance (MR) Lymphangiography, which is performed by injecting gadolinium-based contrast material into groin lymph nodes, overcomes these limitations. T2-weighted imaging plays a complementary role to DCE MR Lymphangiography in the assessment of CCLs. DCE MR Lymphangiography demonstrates preserved integrity or any abnormality of the CCLs (including blockage or leak). The technique has recently been used in evaluating pulmonary lymphatic perfusion syndrome in children with plastic bronchitis, neonatal lymphatic flow disorders, and nontraumatic chylothorax. It is useful in identification of the source of chylous ascites and contributes to understanding of the anatomy of lymphatic malformations. It is successfully used for planning of embolization of aberrant lymphatic channels in a variety of lymphatic flow disorders. This review discusses the anatomy and function of the lymphatic system, the evolution of imaging of the lymphatic system, and DCE MR Lymphangiography technique and its applications in children. ©RSNA, 2017.
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treatment of congenital pulmonary lymphangiectasia using ethiodized oil Lymphangiography
Journal of Perinatology, 2014Co-Authors: Megan M Gray, Maxim Itkin, K Z Kovatis, Tami Stuart, E Enlow, Marc S Keller, Heather FrenchAbstract:Historically, congenital pulmonary lymphangiectasia (CPL) has had poor treatment outcomes despite aggressive therapy. There are recent reports of ethiodized oil (Lipiodol) Lymphangiography successfully treating lymphatic leakage in adults. In this report, we describe two infants with CPL complicated by chylothoraces successfully treated by instillation of ethiodized oil into the lymphatic system. Congenital atresia of the thoracic duct was demonstrated on the lymphangiogram in both patients before treatment. Both patients have shown good short-term outcomes without supplemental oxygen or fat restricted diets at 9 months of age. Ethiodized oil Lymphangiography represents a new treatment modality for some patients with CPL.
Mathias Langer - One of the best experts on this subject based on the ideXlab platform.
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posttraumatic edema of the lower extremities evaluation of the lymphatic vessels with magnetic resonance Lymphangiography
Journal of Vascular Surgery, 2009Co-Authors: Christian Lohrmann, Etelka Foeldi, Gunther Felmerer, Gregor Pache, Oliver Schaefer, Mathias LangerAbstract:Objective To assess for the first time the morphology of the lymphatic system in patients with posttraumatic edema of the lower extremities by magnetic resonance (MR) imaging using the interstitial Lymphangiography technique Materials and Methods Six patients with posttraumatic edema in eight of their 12 lower extremities were examined by MR Lymphangiography. Eighteen mL of gadoteridol and one mL of mepivacainhydrochloride 1% were subdivided into 10 portions and injected intracutaneously. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For MR Lymphangiography, a 3D-spoiled gradient-echo sequence was used. Results In five of the eight (63%) traumatized lower extremities, enlarged lymphatic vessels were detected, with the largest diameter measuring 5 mm. Additionally, a fast lymphatic outflow was observed in seven of the eight (88%) traumatized legs with enhancement of the inguinal lymph nodes already in the first image acquisition 15 minutes after contrast material injection. In two of the eight (25%) traumatized lower extremities, an extensive network of collateral lymphatic vessels was detected at the level of the calf. In both extremities, lymphatic collateralization involved not only the epifascial but also the subfascial lymphatic system. In one patient, who sustained a trauma of the left lower leg with tibial fracture, a small aneurysmatic widening of 7 mm could be detected at the middle level of the calf. Conclusion MR Lymphangiography is a safe and accurate minimal-invasive imaging modality for the evaluation of the lymphatic circulation in patients with posttraumatic edema of the lower extremities. If the extent of lymphatic damage is unclear at the initial clinical examination or requires a better definition for optimal therapeutic planning, MR Lymphangiography is able to identify the anatomic and physiological derangements and to establish an objective baseline.
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mr Lymphangiography for the assessment of the lymphatic system in patients undergoing microsurgical reconstructions of lymphatic vessels
Microvascular Research, 2008Co-Authors: Christian Lohrmann, Etelka Foeldi, Gunther Felmerer, J P Bartholoma, Mathias LangerAbstract:Abstract Objective To assess the morphology of the lymphatic system pre- and postoperatively in patients undergoing microsurgical reconstructions of the lymphatic vessels. Materials and methods 8 lower extremities in 4 consecutive patients with secondary unilateral lymphedema of the lower extremities were examined by MR Lymphangiography. 18 mL of gadoteridol and 1 mL of mepivacainhydrochloride 1% were subdivided into 10 portions and injected intracutaneously into the dorsal aspect of each foot at the region of the four interdigital webs and medial to the first proximal phalanx. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For MR Lymphangiography a 3D-spoiled gradient-echo sequence was used. For evaluation of the lymphedema a heavily T2-weighted 3D-TSE sequence was performed. Results In 2 patients the 3D-TSE sequence demonstrated a decrease of the epifascial lymphedema in the postoperative acquisitions, whereby MR Lymphangiography displayed an improvement of dermal-back areas and collateral lymphatic vessels. In one patient the epifascial lymphedema of the lower extremity decreased, whereas the diameter of the lymphatic vessels showed a constant diameter of 2 mm. In one patient with a lymphocutaneous fistula at the level of the right groin, the feeding lymphatic vessels and contrast media extravasation could clearly be visualized. The 3D-TSE sequence demonstrated an epi- as well as subfascial lymphedema of the right leg. Conclusion MR Lymphangiography is a safe and accurate diagnostic imaging method for the pre- and postoperative evaluation of the lymphatic circulation in patients undergoing microlymphatic surgery. Due to the minimal-invasiveness and lack of radiation, diagnostic follow-up MR Lymphangiography examinations can be performed routinely and with no risk for the patient.
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interstitial mr Lymphangiography a diagnostic imaging method for the evaluation of patients with clinically advanced stages of lymphedema
Acta Tropica, 2007Co-Authors: Christian Lohrmann, Etelka Foeldi, J P Bartholoma, Mathias LangerAbstract:Abstract Background To assess the feasibility of interstitial magnetic resonance Lymphangiography with intracutaneous injection of a commercially available, non-ionic, extracellular paramagnetic contrast agent, to visualize lymphatic vessels in patients with clinically advanced stages of primary lymphedema. Methods Sixteen lower extremities in 8 patients with clinically advanced stages of primary lymphedema were examined with magnetic resonance Lymphangiography. A 18 mL of gadodiamide and 2 mL of mepivacainhydrochloride 1% were subdivided into 10 portions and injected intracutaneously into the dorsal aspect of both feet. For MRL, a 3D spoiled gradient-echo sequence (Volumetric Interpolated Breathold Examination, VIBE) was performed. Results The beaded appearance of lymphatic vessels extending from the injection site was detected in all 16 lower extremities (100%). In 10 lower extremities (63%), lymphatic vessels of the upper leg could be visualized. A contrast enhancement was observed in 10/16 inguinal lymph node groups (63%). In 12 lower extremities (75%) collateral vessels with dermal back-flow areas between lymphatic vessels were seen. Conclusion Magnetic resonance Lymphangiography is safe, technically feasible, and assists the clinician in the therapeutic planning of patients with clinically advanced stages of primary lymphedema by imaging the pathologically modified lymphatic vessels and accompanying complications non-invasively.
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indirect magnetic resonance Lymphangiography in patients with lymphedema preliminary results in humans
European Journal of Radiology, 2006Co-Authors: Christian Lohrmann, Etelka Foeldi, Mathias LangerAbstract:Abstract Purpose To assess the feasibility of indirect magnetic resonance (MR) Lymphangiography with intracutaneous injection of gadodiamide, a commercially available, non-ionic, extracellular paramagnetic contrast agent for the detection of lymphatic vessels in patients with lymphedema. Materials and methods In 2005, three patients with lymphedema of the lower extremities (1 primary, 2 secondary) were referred by the Foeldi Clinic for Lymphology for indirect magnetic resonance Lymphangiography. 4.5 mL of gadodiamide and 0.5 mL of mepivacainhydrochloride 1% were injected intracutaneously into the dorsal aspect of each foot. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For indirect magnetic resonance Lymphangiography, a 3D Fast Low Angle Shot (FLASH) sequence (TR/TE: 5.1/1.23; flip angle: 25; matrix: 448 × 448; bandwidth: 330 Hz/pixel; 6/8 rectangular field of view with a maximum dimension of 500 mm; slices: 88; voxel size: 2.0 mm × 1.0 mm × 1.0 mm; acquisition time: 0 min 31 s) was used. Results Indirect magnetic resonance Lymphangiography depicted lymphatic vessels of the lower and upper leg, and inguinal lymph nodes in all three patients. After 5 min of contrast material application, concomitant venous enhancement was detected. Collateral vessels with dermal back-flow were seen in two patients. A lymphocele in the inguinal region with the afferent lymphatic vessel was depicted in one patient. Conclusion In the presented small study group, indirect magnetic resonance Lymphangiography was technically feasible, and no complications were observed after intracutaneous injection of gadodiamide. Visualizing the lymphatic vessels and accompanying complications non-invasively and without the use of radiation, the presented method has the capability to become a routine diagnostic imaging tool in patients with primary and secondary lymphedema. The method is not able to characterize lymph node morphology, but could provide additional information about the lymphatic vessels when lymph nodes are examined, e.g. with super-paramagnetic iron oxide particles.
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high resolution mr Lymphangiography in patients with primary and secondary lymphedema
American Journal of Roentgenology, 2006Co-Authors: Christian Lohrmann, Etelka Foeldi, Oliver Speck, Mathias LangerAbstract:OBJECTIVE. The objective of our study was to evaluate the feasibility of high-resolution MR Lymphangiography with intracutaneous injection of gadodiamide, a commercially available, nonionic, extracellular paramagnetic contrast agent, for the visualization of lymphatic vessels in patients with primary and secondary lymphedema.CONCLUSION. High-resolution MR Lymphangiography is safe, is technically feasible, and has the potential to become a diagnostic imaging tool for patients with lymphedema.
Christian Lohrmann - One of the best experts on this subject based on the ideXlab platform.
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posttraumatic edema of the lower extremities evaluation of the lymphatic vessels with magnetic resonance Lymphangiography
Journal of Vascular Surgery, 2009Co-Authors: Christian Lohrmann, Etelka Foeldi, Gunther Felmerer, Gregor Pache, Oliver Schaefer, Mathias LangerAbstract:Objective To assess for the first time the morphology of the lymphatic system in patients with posttraumatic edema of the lower extremities by magnetic resonance (MR) imaging using the interstitial Lymphangiography technique Materials and Methods Six patients with posttraumatic edema in eight of their 12 lower extremities were examined by MR Lymphangiography. Eighteen mL of gadoteridol and one mL of mepivacainhydrochloride 1% were subdivided into 10 portions and injected intracutaneously. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For MR Lymphangiography, a 3D-spoiled gradient-echo sequence was used. Results In five of the eight (63%) traumatized lower extremities, enlarged lymphatic vessels were detected, with the largest diameter measuring 5 mm. Additionally, a fast lymphatic outflow was observed in seven of the eight (88%) traumatized legs with enhancement of the inguinal lymph nodes already in the first image acquisition 15 minutes after contrast material injection. In two of the eight (25%) traumatized lower extremities, an extensive network of collateral lymphatic vessels was detected at the level of the calf. In both extremities, lymphatic collateralization involved not only the epifascial but also the subfascial lymphatic system. In one patient, who sustained a trauma of the left lower leg with tibial fracture, a small aneurysmatic widening of 7 mm could be detected at the middle level of the calf. Conclusion MR Lymphangiography is a safe and accurate minimal-invasive imaging modality for the evaluation of the lymphatic circulation in patients with posttraumatic edema of the lower extremities. If the extent of lymphatic damage is unclear at the initial clinical examination or requires a better definition for optimal therapeutic planning, MR Lymphangiography is able to identify the anatomic and physiological derangements and to establish an objective baseline.
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mr Lymphangiography for the assessment of the lymphatic system in patients undergoing microsurgical reconstructions of lymphatic vessels
Microvascular Research, 2008Co-Authors: Christian Lohrmann, Etelka Foeldi, Gunther Felmerer, J P Bartholoma, Mathias LangerAbstract:Abstract Objective To assess the morphology of the lymphatic system pre- and postoperatively in patients undergoing microsurgical reconstructions of the lymphatic vessels. Materials and methods 8 lower extremities in 4 consecutive patients with secondary unilateral lymphedema of the lower extremities were examined by MR Lymphangiography. 18 mL of gadoteridol and 1 mL of mepivacainhydrochloride 1% were subdivided into 10 portions and injected intracutaneously into the dorsal aspect of each foot at the region of the four interdigital webs and medial to the first proximal phalanx. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For MR Lymphangiography a 3D-spoiled gradient-echo sequence was used. For evaluation of the lymphedema a heavily T2-weighted 3D-TSE sequence was performed. Results In 2 patients the 3D-TSE sequence demonstrated a decrease of the epifascial lymphedema in the postoperative acquisitions, whereby MR Lymphangiography displayed an improvement of dermal-back areas and collateral lymphatic vessels. In one patient the epifascial lymphedema of the lower extremity decreased, whereas the diameter of the lymphatic vessels showed a constant diameter of 2 mm. In one patient with a lymphocutaneous fistula at the level of the right groin, the feeding lymphatic vessels and contrast media extravasation could clearly be visualized. The 3D-TSE sequence demonstrated an epi- as well as subfascial lymphedema of the right leg. Conclusion MR Lymphangiography is a safe and accurate diagnostic imaging method for the pre- and postoperative evaluation of the lymphatic circulation in patients undergoing microlymphatic surgery. Due to the minimal-invasiveness and lack of radiation, diagnostic follow-up MR Lymphangiography examinations can be performed routinely and with no risk for the patient.
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interstitial mr Lymphangiography a diagnostic imaging method for the evaluation of patients with clinically advanced stages of lymphedema
Acta Tropica, 2007Co-Authors: Christian Lohrmann, Etelka Foeldi, J P Bartholoma, Mathias LangerAbstract:Abstract Background To assess the feasibility of interstitial magnetic resonance Lymphangiography with intracutaneous injection of a commercially available, non-ionic, extracellular paramagnetic contrast agent, to visualize lymphatic vessels in patients with clinically advanced stages of primary lymphedema. Methods Sixteen lower extremities in 8 patients with clinically advanced stages of primary lymphedema were examined with magnetic resonance Lymphangiography. A 18 mL of gadodiamide and 2 mL of mepivacainhydrochloride 1% were subdivided into 10 portions and injected intracutaneously into the dorsal aspect of both feet. For MRL, a 3D spoiled gradient-echo sequence (Volumetric Interpolated Breathold Examination, VIBE) was performed. Results The beaded appearance of lymphatic vessels extending from the injection site was detected in all 16 lower extremities (100%). In 10 lower extremities (63%), lymphatic vessels of the upper leg could be visualized. A contrast enhancement was observed in 10/16 inguinal lymph node groups (63%). In 12 lower extremities (75%) collateral vessels with dermal back-flow areas between lymphatic vessels were seen. Conclusion Magnetic resonance Lymphangiography is safe, technically feasible, and assists the clinician in the therapeutic planning of patients with clinically advanced stages of primary lymphedema by imaging the pathologically modified lymphatic vessels and accompanying complications non-invasively.
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indirect magnetic resonance Lymphangiography in patients with lymphedema preliminary results in humans
European Journal of Radiology, 2006Co-Authors: Christian Lohrmann, Etelka Foeldi, Mathias LangerAbstract:Abstract Purpose To assess the feasibility of indirect magnetic resonance (MR) Lymphangiography with intracutaneous injection of gadodiamide, a commercially available, non-ionic, extracellular paramagnetic contrast agent for the detection of lymphatic vessels in patients with lymphedema. Materials and methods In 2005, three patients with lymphedema of the lower extremities (1 primary, 2 secondary) were referred by the Foeldi Clinic for Lymphology for indirect magnetic resonance Lymphangiography. 4.5 mL of gadodiamide and 0.5 mL of mepivacainhydrochloride 1% were injected intracutaneously into the dorsal aspect of each foot. MR imaging was performed with a 1.5-T system equipped with high-performance gradients. For indirect magnetic resonance Lymphangiography, a 3D Fast Low Angle Shot (FLASH) sequence (TR/TE: 5.1/1.23; flip angle: 25; matrix: 448 × 448; bandwidth: 330 Hz/pixel; 6/8 rectangular field of view with a maximum dimension of 500 mm; slices: 88; voxel size: 2.0 mm × 1.0 mm × 1.0 mm; acquisition time: 0 min 31 s) was used. Results Indirect magnetic resonance Lymphangiography depicted lymphatic vessels of the lower and upper leg, and inguinal lymph nodes in all three patients. After 5 min of contrast material application, concomitant venous enhancement was detected. Collateral vessels with dermal back-flow were seen in two patients. A lymphocele in the inguinal region with the afferent lymphatic vessel was depicted in one patient. Conclusion In the presented small study group, indirect magnetic resonance Lymphangiography was technically feasible, and no complications were observed after intracutaneous injection of gadodiamide. Visualizing the lymphatic vessels and accompanying complications non-invasively and without the use of radiation, the presented method has the capability to become a routine diagnostic imaging tool in patients with primary and secondary lymphedema. The method is not able to characterize lymph node morphology, but could provide additional information about the lymphatic vessels when lymph nodes are examined, e.g. with super-paramagnetic iron oxide particles.
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high resolution mr Lymphangiography in patients with primary and secondary lymphedema
American Journal of Roentgenology, 2006Co-Authors: Christian Lohrmann, Etelka Foeldi, Oliver Speck, Mathias LangerAbstract:OBJECTIVE. The objective of our study was to evaluate the feasibility of high-resolution MR Lymphangiography with intracutaneous injection of gadodiamide, a commercially available, nonionic, extracellular paramagnetic contrast agent, for the visualization of lymphatic vessels in patients with primary and secondary lymphedema.CONCLUSION. High-resolution MR Lymphangiography is safe, is technically feasible, and has the potential to become a diagnostic imaging tool for patients with lymphedema.
Thomas A Waldmann - One of the best experts on this subject based on the ideXlab platform.
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lymphatic drainage imaging of breast cancer in mice by micro magnetic resonance Lymphangiography using a nano size paramagnetic contrast agent
Journal of the National Cancer Institute, 2004Co-Authors: Hisataka Kobayashi, Satomi Kawamoto, Yoshio Sakai, Peter L Choyke, Robert A Star, Martin W Brechbiel, Noriko Sato, Yutaka Tagaya, John C Morris, Thomas A WaldmannAbstract:Background: The presence of lymph node metastases is an important factor in breast cancer patient prognosis. Therefore, the precise identification of sentinel lymph nodes in these patients is critical. Improving current magnetic resonance (MR) imaging methods using a newly synthesized nano-size paramagnetic molecule, G6, as a contrast agent, provides an attractive means toward attaining this goal. Methods: A four-dimensional method of micro-MR Lymphangiography using G6 (9 nm/240 kd) was developed to visualize the lymphatic ducts and lymph nodes draining mouse mammary tumors over time. The ability of micro-MR Lymphangiography with the G6 contrast agent to visualize lymphatic drainage of normal mouse mammary tissue was compared with that of the conventional MR contrast agent, Gd-[DTPA]-dimeglumine (<1 kd). Lymphatic drainage in spontaneous and xenografted breast tumor models was visualized using the G6 contrast agent. Results: Draining lymphatic ducts and lymph nodes were clearly visualized in the mammary tissue of normal mice and in spontaneous and xenografted breast tumor models after a direct mammary gland or peritumoral injection of G6. Gd-[DTPA]-dimeglumine, by contrast, failed to depict lymphatic flow from the mammary tissue in normal mice using the same method. Micro-MR Lymphangiography using the G6 contrast agent revealed the absence of filling in the metastatic foci of affected lymph nodes. Conclusions: The superior temporal and spatial resolution of micro-MR Lymphangiography using the contrast agent G6 may facilitate the study of tumor lymphatic drainage and lymphatic metastasis in both experimental animals and clinical medicine. In addition, this may be a powerful new method for sentinel lymph node localization in human breast cancer.
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lymphatic drainage imaging of breast cancer in mice by micro magnetic resonance Lymphangiography using a nano size paramagnetic contrast agent
Journal of the National Cancer Institute, 2004Co-Authors: Hisataka Kobayashi, Satomi Kawamoto, Yoshio Sakai, Peter L Choyke, Robert A Star, Martin W Brechbiel, Noriko Sato, Yutaka Tagaya, John C Morris, Thomas A WaldmannAbstract:BACKGROUND: The presence of lymph node metastases is an important factor in breast cancer patient prognosis. Therefore, the precise identification of sentinel lymph nodes in these patients is critical. Improving current magnetic resonance (MR) imaging methods using a newly synthesized nano-size paramagnetic molecule, G6, as a contrast agent, provides an attractive means toward attaining this goal. METHODS: A four-dimensional method of micro-MR Lymphangiography using G6 (9 nm/240 kd) was developed to visualize the lymphatic ducts and lymph nodes draining mouse mammary tumors over time. The ability of micro-MR Lymphangiography with the G6 contrast agent to visualize lymphatic drainage of normal mouse mammary tissue was compared with that of the conventional MR contrast agent, Gd-[DTPA]-dimeglumine (<1 kd). Lymphatic drainage in spontaneous and xenografted breast tumor models was visualized using the G6 contrast agent. RESULTS: Draining lymphatic ducts and lymph nodes were clearly visualized in the mammary tissue of normal mice and in spontaneous and xenografted breast tumor models after a direct mammary gland or peritumoral injection of G6. Gd-[DTPA]-dime-glumine, by contrast, failed to depict lymphatic flow from the mammary tissue in normal mice using the same method. Micro-MR Lymphangiography using the G6 contrast agent revealed the absence of filling in the metastatic foci of affected lymph nodes. CONCLUSIONS: The superior temporal and spatial resolution of micro-MR Lymphangiography using the contrast agent G6 may facilitate the study of tumor lymphatic drainage and lymphatic metastasis in both experimental animals and clinical medicine. In addition, this may be a powerful new method for sentinel lymph node localization in human breast cancer.
