• Title/Summary/Keyword: Lymphatic imaging

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Demonstration of the Usefulness of Optical Coherence Tomography in Imaging a Mouse Tail Model of Lymphedema

  • Kim, Hui Dong;Kim, Dong Kyu;Chae, Yu-Gyeong;Park, Seok Gyo;Kim, Ghi Chan;Jeong, Ho Joong;Sim, Young-Joo;Ahn, Yeh-Chan
    • Current Optics and Photonics
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    • v.1 no.2
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    • pp.132-137
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    • 2017
  • To investigate the usefulness of optical coherence tomography (OCT) for imaging lymphedema, we directly compared it to other histological methods in a mouse model of lymphedema. We performed detailed imaging of the lymphedema lesion on a mouse tail. We imaged the mouse tail in vivo with OCT and created histopathological samples. We constructed a spectrometer-based OCT system using a fiber-optic Michelson interferometer. The light was directed to 50:50 couplers that split the light into reference and sample arms. Backscattered light from a reference mirror and the sample produced an interference fringe. An OCT image of the lymphedema model revealed an inflammatory reaction of the skin that was accompanied by edema, leading to an increase in the light attenuation in the dermal and subcutaneous layers. Similar to OCT image findings, histological biopsy showed an inflammatory response that involved edema, increased neutrophils in epidermis and subdermis, and lymphatic microvascular dilatation. Furthermore, the lymphedema model showed an increase in thickness of the dermis in both diagnostic studies. In the mouse tail model of lymphedema, OCT imaging showed very similar results to other histological examinations. OCT provides a quick and useful diagnostic imaging technique for lymphedema and is a valuable addition or complement to other noninvasive imaging tools.

MRI Features for Prediction Malignant Intra-Mammary Lymph Nodes: Correlations with Mammography and Ultrasound

  • Kim, Meejung;Kang, Bong Joo;Park, Ga Eun
    • Investigative Magnetic Resonance Imaging
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    • v.26 no.2
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    • pp.135-149
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    • 2022
  • Purpose: To assess clinically significant imaging findings of malignant intramammary lymph nodes (IMLNs) in breast cancer patients and to evaluate their diagnostic performance in predicting malignant IMLN. Materials and Methods: A total of 110 cases with IMLN of BI-RADS category 3 or more, not typical benign IMLN, in MR of breast cancer patients between January 2016 and January 2021 were retrospectively reviewed. After excluding 33 cases, 77 cases were finally included. Among them, 58 and 19 were confirmed as benign and malignant, respectively. Qualitative and quantitative MR imaging features of the IMLN were retrospectively analyzed. Sizes and final assessment categories of IMLN on MRI, mammography, and ultrasound were reviewed. Diagnostic performances of imaging features on MRI, mammography, and ultrasound were then evaluated. Results: For qualitative MR features, shape, margin, and preserved central hilum were significantly different between benign and malignant groups (P < 0.05). For quantitative MR features, long diameter over 6 mm, short diameter over 4 mm, and cortical thickening over 3 mm showed high sensitivities in predicting malignant IMLNs (89.5%, 94.7%, and 100%, respectively). Size exceeding 1 cm showed high specificity and accuracy in predicting malignant IMLN on MR, mammography, and ultrasound (91.4% and 80.5%; 96.6% and 79.25; 98.3% and 80.5%, respectively). Conclusion: Various MR imaging features and size can be helpful for predicting malignant IMLN in breast cancer patients.

Diagnostic value of magnetic resonance imaging using superparamagnetic iron oxide for axillary node metastasis in patients with breast cancer: a meta-analysis

  • Lee, Ru Da;Park, Jung Gu;Ryu, Dong Won;Kim, Yoon Seok
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.297-306
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    • 2018
  • Objectives: Identification of axillary metastases in breast cancer is important for staging disease and planning treatment, but current techniques are associated with a number of adverse events. This report evaluates the diagnostic accuracy of superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) techniques for identification of axillary metastases in breast cancer patients. Methods: We performed a meta-analysis of previous studies that compared SPIO enhanced MRI with histological diagnosis after surgery or biopsy. We searched PubMed, Ovid, Springer Link, and Cochrane library to identify studies reporting data for SPIO enhanced MRI for detection of axillary lymph node metastases in breast cancer until December 2013. The following keywords were used: "magnetic resonance imaging AND axilla" and "superparamagnetic iron oxide AND axilla". Eligible studies were those that compared SPIO enhanced MRI with histological diagnosis. Sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analyses were done. Study quality and heterogeneity were also assessed. Results: There were 7 publications that met the criteria for inclusion in our meta-analysis. SROC curve analysis for per patient data showed an overall sensitivity of 0.83 (95% Confidence interval (CI): 0.75-0.89) and overall specificity of 0.97 (95% CI: 0.94-0.98). Overall weighted area under the curve was 0.9563. Conclusions: SPIO enhanced MRI showed a trend toward high diagnostic accuracy in detection of lymph node metastases for breast cancer. So, when the breast cancer patients has axillary metastases histologically, SPIO enhanced MRI may be effective diagnostic imaging modality for axillary metastases.

Popliteal Lymphography in a Dog with Chylothorax

  • Bang, Sohyun;Lee, Hanbin;Park, Daehwan;An, Taegeon;Kim, Hyunryung;Yu, Jin;Yoon, Hyunglok;An, Gayeon;Oh, Hyehong;Chang, Jinhwa;Kim, Gonhyung;Chang, Dongwoo
    • Journal of Veterinary Clinics
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    • v.35 no.6
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    • pp.290-293
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    • 2018
  • Signalment: A dog which had been hit by car a month prior and had been experiencing recurrent pleural chyle effusion was referred to Chung-buk National University Animal Medical Center. The clinical signs included tachypnea and salivation. Results: Ultrasound-guided popliteal lymphography was performed. The computed tomography imaging revealed that the thoracic duct was ruptured and the lymph was leaking into the cranial mediastinal region. After this discovery, thoracic duct ligation was performed. The ultrasound-guided popliteal lymphography was repeated after the surgery. The second computed tomography imaging revealed that the thoracic duct rupture was resolved. Clinical relevance: We identified the etiology of chylothorax through the computed tomographic lymphography and imaged specific leakage areas. After surgery, the computed tomography imgaing confirmed the lymphatic flow modification and the treatment was successful.

Sentinel Lymph Node Imaging in Breast Cancer (유방암에서 전초림프절 영상)

  • Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.33 no.3
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    • pp.243-246
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    • 1999
  • Currently, dissection of the axillary or regional lymph nodes is considered the standard staging procedure in breast cancer. However, accumulating evidence is becoming available that the sentinel node concept may provide the same or even better staging information. In the case of melanoma, it is proven that the histological characteristics of the sentinel node reflect the histological characteristics of the distal part of the lymphatic basin. Morbidity can be reduced significantly by the use of sentinel node dissection as several authors have reported successful introduction of this technique into clinical practice. But in breast cancer patients, there are signigicant differences in practice relating to the technology, such as radiopharmaceuticals, injection sites, volume of injectate, combination with vital blue dye, preoperative lymphoscintigraphy, etc. Valuable reports on these topics appeared in recent journals. This review is a summary of those reports for nuclear physicians interested in sentinel node detection by lymphoscintigraphy in breast cancer patients.

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Postoperative Chylothorax: the Use of Dynamic Magnetic Resonance Lymphangiography and Thoracic Duct Embolization

  • Lee, Chae Woon;Koo, Hyun Jung;Shin, Ji Hoon;Kim, Mi young;Yang, Dong Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.3
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    • pp.182-186
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    • 2018
  • Dynamic enhanced magnetic resonance lymphangiography can be used to provide anatomic and dynamic information for various lymphatic diseases, including thoracic duct injury, and can also help to guide the thoracic duct embolization procedure. We present a case of postoperative chylothorax demonstrated by dynamic enhanced MR lymphangiography. In this case, the chyle leakage site and location of cisterna chyli were clearly visualized by dynamic enhanced MR lymphangiography, thus allowing for management with thoracic duct embolization.

Optimizing Treatment of Breast Cancer Related Lymphedema Using Combined DIEP Flap and Lymphedema Surgery

  • Chang, Edward I.
    • Archives of Plastic Surgery
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    • v.49 no.2
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    • pp.150-157
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    • 2022
  • Patients undergoing treatment for breast cancer who undergo an axillary dissection and require adjuvant therapies such as radiation and chemotherapy are at high risk of developing lymphedema of the associated extremity. Historically, patients with lymphedema were treated with ablative procedures aimed simply to remove excess fluid and adiposity; however, the field of lymphatic surgery employing super-microsurgery techniques has witnessed tremendous advances in a relatively short period of time. Advancements in surgical instruments, microscope magnification and optics, imaging technology, and surgeon experience have ushered in a new era of hope to treat patients suffering from breast cancer-related lymphedema (BCRL). Here we aim to present the available options for patients suffering from BCRL, and the pinnacle in reconstruction and restoration for these patients.

Primary Angiosarcoma of the Mesentery: A Case Report (장간막에서 발생한 원발성 혈관육종: 증례 보고)

  • Hyeon Wook Kang;Ji Yeol Shin;Ju Wan Choi
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.423-427
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    • 2020
  • Angiosarcoma is a malignant endothelial cell tumor of lymphatic or vascular origin and is most commonly found in the skin and soft tissue. Primary mesenteric angiosarcoma has rarely been reported. Here, we present a case of primary mesenteric angiosarcoma manifesting as a gradually enhancing mass along with necrosis and hemorrhage.

Muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge is associated with cervical lymph node metastasis

  • Min, Seung-Ki;Myoung, Hoon;Lee, Jong-Ho;Kim, Myung-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.3
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    • pp.133-138
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    • 2016
  • Objectives: To assess the association between muscle invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis on the basis of preoperative magnetic resonance imaging (MRI). Materials and Methods: Twenty-six patients with oral squamous cell carcinoma of the posterior mandibular alveolar ridge were evaluated by MRI. The associations between cervical lymph node metastasis and independent factors evaluated by MRI were analyzed. Overall survival was also analyzed in this manner. Representative biopsy specimens were stained with anti-podoplanin and anti-CD34 antibodies. Results: Mylohyoid muscle invasion was associated with cervical lymph node metastasis. A combinational factor of mylohyoid and/or buccinator muscle invasion was also associated with cervical lymph node metastasis. Cervical lymph node metastasis and masticator space invasion had a negative effect on overall survival. No lymphatic vessels were identified near the tumor invasion front within the mandible. In contrast, lymphatic vessels were identified near the front of tumor invasion in the muscles. Conclusion: This study demonstrates an association between muscular invasion by oral squamous cell carcinoma of the posterior mandibular alveolar ridge and cervical lymph node metastasis.

Diagnostic Effectiveness of USPIO versus Gadolinium Based MRI for Axillary Metastasis in Breast Cancer: A Meta-analysis

  • Kim, Yoonseok;Jae, Eunae;Park, Junggu
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.1
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    • pp.37-46
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    • 2015
  • Purpose: This report compared the diagnostic effectiveness between ultrasmall superparamagnetic iron oxide (USPIO) and gadolinium (Gd) based magnetic resonance imaging (MRI) for differentiation of axillary status in breast cancer patients. Materials and Methods: The present authors performed a meta-analysis of previous studies that compared USPIO or Gd based MRI with histological diagnosis after surgery or biopsy. We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, Ovid databases and references of articles to identify studies reporting data until December 2013. Pooled sensitivity and specificity were calculated for every study; summary receiver operating characteristic and subgroup analysis was done. Analyses of study quality and heterogeneity were also assessed. Results: There were 14 publications that met the criteria for inclusion in our meta-analysis. USPIO based MRI showed 0.83 (95% CI: 0.75-0.89) and 0.97 (95% CI: 0.94-0.98) for pooled sensitivity and specificity, respectively. Gd based MRI represented pooled sensitivity and specificity of 0.61 (95% CI: 0.55-0.67) and 0.90 (95% CI: 0.87-0.92) for each. Overall weighted area under the curve for USPIO and Gd based MRI were 0.9563 and 0.9051, respectively. Conclusion: USPIO based MRI had a tendency toward high pooled sensitivity and specificity in detection of axillary metastases for breast cancer. This result may mean that USPIO based MRI could be used as complementary modality to differentiate axillary status more precisely, and assist in the decision-making process regarding possible invasive procedures, such as sentinel node biopsy.