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Title: Indirect MR lymphangiography of the head and neck using conventional gadolinium contrast: A pilot study in humans

Journal Article · · International Journal of Radiation Oncology, Biology and Physics
 [1];  [2];  [3];  [4];  [1];  [1];  [5];  [1]
  1. Department of Radiation Oncology, Stanford University, Stanford, CA (United States)
  2. Department of Mechanical Engineering, Stanford University, Stanford, CA (United States)
  3. Department of General Surgery, Singapore General Hospital (Singapore)
  4. Department of Radiology, University of California, Los Angeles, CA (United States)
  5. Department of Radiology, Stanford University, Stanford, CA (United States)

Purpose: To evaluate indirect magnetic resonance lymphangiography (MR-LAG) using interstitial injection of conventional gadolinium contrast (gadoteridol and gadopentetate dimeglumine) for delineating the primary lymphatic drainage of head-and-neck sites. Methods and Materials: We performed head-and-neck MR-LAG in 5 healthy volunteers, with injection of dermal and mucosal sites. We evaluated the safety of the procedure, the patterns of enhancement categorized by injection site and nodal level, the time course of enhancement, the optimal concentration and volume of contrast, and the optimal imaging sequence. Results: The worst side effects of interstitial contrast injection were brief, mild pain and swelling at the injected sites that were self-limited. MR-LAG resulted in consistent visualization of the primary lymphatic drainage pattern specific to each injected site, which was reproducible on repeated examinations. The best enhancement was obtained with injection of small volumes (0.3-0.5 mL) of either agent diluted, imaging within 5-15 min of injection, and a three-dimensional fast spoiled gradient echo sequence with magnetization transfer. Conclusions: We found head-and-neck MR-LAG to be a safe, convenient imaging method that provides functional information about the lymphatic drainage of injected sites. Applied to head-and-neck cancer, it has the potential to identify sites at highest risk of occult metastatic spread for radiotherapy or surgical planning, and possibly to visualize micrometastases.

OSTI ID:
20850122
Journal Information:
International Journal of Radiation Oncology, Biology and Physics, Vol. 66, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2006.05.045; PII: S0360-3016(06)00969-2; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
Country of Publication:
United States
Language:
English

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