Ultrasonographic Evaluation of superficial lymph node metastases in melanoma
ABSTRACT The aims of the present work were to assess the diagnostic accuracy of ultrasonographic evaluation of superficial lymph nodes in patients with cutaneous melanoma and to describe the sonographic characteristics which permit early detection of neoplastic nodal involvement. Eighty-seven patients (89 lymph node sites) were studied for approximately a 3-year period, with a minimal surveillance time of 1 year. The ultrasonographic imaging equipment utilized were a 10 MHz scanner with a mechanical and one with 10 MHz electronic linear probe. The characteristics considered indicative of possible metastatic involvement were: round shape (short to long axis ratio > 0.5), no central hilus, nodular areas within the lymph node, sinuosity of the lymph node edges and lymph node with regular morphology and echostructure but with maximum diameter greater than 3 cm. Generally inguinal and axillary lymph nodes are larger than cervical ones. Of the 89 sites explored, 32 were considered 'suspect'. All 32 of these were subjected to cytology using ultrasound-guided, fine needle aspiration. The remaining 56 came in for a periodic control examination during a year. Thirteen of the 32 'suspect' lymph nodes proved positive at the pathologic examination. Two patients whose ultrasound diagnosis was negative developed metastases within 2 to 4 months (ultrasound false negatives). Our study indicates that there are sonographic features indicative of lymph node metastases from melanoma even in the early stages of the disease. Ultrasound scanning, therefore, is a useful diagnostic tool in the follow-up of melanoma patients, identifying which should be subjected to further testing with needle biopsy.
- SourceAvailable from: Zhongwei Zhi
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- ". Also, color Doppler ultrasound (CDUS) provided functional imaging of the LNs which can be used to classify nodes as being reactive, metastatic, tuberculous, cystic, or enlarged secondary to lymphoma  "
ABSTRACT: Lymphatic vessels are a part of the circulatory system in vertebrates that maintain tissue fluid homeostasis and drain excess fluid and large cells that cannot easily find their way back into venous system. Due to the lack of noninvasive monitoring tools, lymphatic vessels are known as forgotten circulation. However, the lymphatic system plays an important role in diseases such as cancer and inflammatory conditions. In this paper, we start to briefly review the current existing methods for imaging lymphatic vessels, mostly involving dye/targeting cell injection. We then show the capability of optical coherence tomography (OCT) for label-free noninvasive in vivo imaging of lymph vessels and nodes. One of the advantages of using OCT over other imaging modalities is its ability to assess label-free blood flow perfusion that can be simultaneously observed along with lymphatic vessels for imaging the microcirculatory system within tissue beds. Imaging the microcirculatory system including blood and lymphatic vessels can be utilized for imaging and better understanding pathologic mechanisms and the treatment technique development in some critical diseases such as inflammation, malignant cancer angiogenesis, and metastasis.IEEE Journal of Selected Topics in Quantum Electronics 03/2014; 20(2):6800510-6800510. DOI:10.1109/JSTQE.2013.2278073 · 3.47 Impact Factor
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- "Sonography of the lymph nodes was the most efficient technical method to detect relapses ( range : 10 – 16% ) in all phases of follow - up . This is in line with recent reports suggesting that lymph nodes sonography improves early detection of locoregional metastases ( Tregnaghi et al , 1997 ; Blum et al , 2000 ) . The efficiency - costs ratio in our study was best at initial staging and the follow - up in stage III . "
ABSTRACT: In a German cohort of 661 melanoma patients the performance, costs and survival benefits of staging methods (history and physical examination; chest X-ray; ultrasonography of the abdomen; high resolution sonography of the peripheral lymph nodes) were assessed at initial staging and during follow-up of stage I/II+III disease. At initial staging, 74% (23 out of 31) of synchronous metastases were first detected by physical examination followed by sonography of the lymph nodes revealing 16% (5 out of 31). Other imaging methods were less efficient (Chest X-ray: one out of 31; sonography of abdomen: two out of 31). Nearly 24% of all 127 first recurrences and 18% of 73 second recurrences developed in patients not participating in the follow-up programme. In follow-up patients detection of first or second recurrence were attributed to history and physical examination on a routine visit in 47 and 52% recurrences, respectively, and to routine imaging procedures in 21 and 17% of cases, respectively. Lymph node sonography was the most successful technical staging procedure indicating 13% of first relapses, but comprised 24% of total costs of follow-up in stage I/II. Routine imaging comprised nearly 50% of total costs for follow-up in stage I/II and in stage III. The mode of detecting a relapse (‘patient vs. doctor-diagnosed’ or ‘symptomatic vs asymptomatic’) did not significantly influence patients overall survival. Taken together, imaging procedures for routine follow-up in stage I/II and stage III melanoma patients were inefficient and not cost-efficient. British Journal of Cancer (2002) 87, 151–157. doi:10.1038/sj.bjc.6600428 www.bjcancer.com © 2002 Cancer Research UKBritish Journal of Cancer 08/2002; 87(2):151-7. DOI:10.1038/sj.bjc.6600428 · 4.82 Impact Factor
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ABSTRACT: Metastatic spread of cancer is one of the major causes of cancer death. The lymphatics contribute to metastatic spread by providing a conduit for the spread of cancer cells. Tumors actively induce new lymphatic formation by deploying growth factors, a process known as lymphangiogenesis. Systemic lymphatic imaging with conventional modalities such as computed tomography, magnetic resonance imaging and ultrasound is limited to morphological evaluation for detection of enlarged lymph nodes; on the other hand, functional lymphatic imaging approaches, including positron emission tomography, dynamic contrast-enhanced MRI, lymphotrophic iron oxide nanoparticle enhanced-MRI have been used to diagnose metastatic cancer in lymph nodes. Recently, new targeted lymphatic imaging techniques including gadolinium- conjugated dendrimer-based MRI, optical imaging using nano-sized molecules based on fluorescence-labeled dendrimers, organic macromolecules, or quantum dots, have been developed. In this chapter, we will explain principles and basic findings of conventional and functional lymphatic imaging and will outline newly developed targeted lymphatic imaging approaches.01/1970: pages 159-184;