Korean J Radiol.  2014 Feb;15(1):29-36. 10.3348/kjr.2014.15.1.29.

Sentinel Node Mapping of VX2 Carcinoma in Rabbit Thigh with CT Lymphography Using Ethiodized Oil

• Lee YJ
• Kim YH
• Lee KH
• Park JH
• Lee HS
• Jung SC
• Joo SM

• KMID: 1711474
• DOI: http://doi.org/10.3348/kjr.2014.15.1.29

Abstract

OBJECTIVE
To assess the feasibility of computed tomography (CT) lymphography using ethiodized oil for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh.
MATERIALS AND METHODS
This experiment received approval from the institutional animal use and care administrative advisory committee. Twenty-three rabbits with VX2 carcinoma in the thigh underwent CT before and after (1 hour, 2 hour) peritumoral injection of 2 mL ethiodized oil. After the CT examination, sentinel nodes were identified by peritumoral injection of methylene blue and subsequently removed. The retrieved sentinel and non-sentinel lymph nodes were investigated with radiographic and pathologic examinations. Based on the comparison of CT findings with those of radiographic and pathologic examinations, the diagnostic performance of CT for sentinel node identification was assessed.
RESULTS
All 23 rabbits showed 53 ethiodized oil retention nodes on post-injection CT and specimen radiography, and 52 methylene blue-stained nodes at the right femoroiliac area. Of the 52 blue-stained sentinel nodes, 50 nodes demonstrated ethiodized oil retention. Thus, the sentinel node detection rate of CT was 96% (50 of 52). On pathologic examination, 28 sentinel nodes in 17 rabbits (nodes/rabbit, mean +/- standard deviation, 1.7 +/- 0.6) harbored metastasis. Twenty seven of the 28 metastatic sentinel nodes were found to have ethiodized oil retention.
CONCLUSION
Computed tomography lymphography using ethiodized oil may be feasible for sentinel node mapping in experimentally induced VX2 carcinoma in the rabbit thigh.

Keyword

Sentinel lymph node; Computed tomography; Lymphography; Lymphatic metastasis; Animal model

MeSH Terms

Animals
Carcinoma/pathology/*radiography/secondary
Contrast Media/*diagnostic use
Ethiodized Oil/*diagnostic use
Feasibility Studies
Female
Injections
Lymph Node Excision/methods
Lymph Nodes/pathology/*radiography
Lymphatic Metastasis/radiography
Lymphography/*methods
Rabbits
Thigh
Tomography, X-Ray Computed/*methods
Contrast Media
Ethiodized Oil

Figure

• 

  Fig. 1 CT lymphography after ethiodized oil injection at peritumoral area in rabbit thigh. A, B. Noncontrast CT images obtained 1 (A) and 2 (B) hours after ethiodized oil injection show nodular high attenuation areas (arrows), suggesting ethiodized oil retention in right femoroiliac lymph nodes. C. Photography obtained after resection of blue-stained lymphatic basin shows blue-stained lymph nodes (arrows). D. Specimen radiography shows ethiodized oil retention (arrows) in blue-stained lymph nodes. E. Photomicrography of removed node demonstrates intranodal lipid droplets (red droplets, arrows), indicating intra-nodal ethiodized oil retention (Oil-Red-O stain; original magnification, × 40).

• 

  Fig. 2 Box-and-whisker plots of measured nodal attenuation values in Hounsfield unit (HU) at noncontrast CT before (pre-injection CT), 1 hour (post-1h CT) and 2 hours (post-2h CT) after ethiodized oil injection. Differences of attenuation values between all three pairs of pre- and post-1h and post-2h CT images were statistically significant (p < 0.0005, respectively).

• 

  Fig. 3 Flow diagram of histologic findings of retrieved lymph nodes. Numbers in parentheses are numbers of rabbits. LN = lymph node

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