MR lymphography for sentinel lymph node detection in patients with oral cavity cancer: Preliminary clinical study.

Abstract

The purpose of this study was to evaluate the feasibility of MR lymphography with interstitial injection of a gadolinium-based contrast agent for identifying sentinel lymph nodes in patients with oral cavity cancer and clinically negative neck. Pretreatment MR lymphography with a differential subsampling with cartesian ordering (DISCO) sequence was performed in 26 patients with resectable oral cavity cancer and clinically negative neck, after peritumoral injection of 1-mL diluted gadobutrol. The accuracy of sentinel lymph node identification by MR lymphography was assessed and compared with the final histopathological results. The MR lymphography consistently visualized the 44 sentinel lymph nodes in all 26 patients. In all but 1 patient with pathologically positive neck, assumed sentinel lymph nodes revealed metastatic involvement. Pretreatment MR lymphography is a safe and feasible imaging technique that can help clinicians identify sentinel lymph nodes with a high risk of occult metastases in patients with oral cavity cancer, enabling focused preoperative biopsy in these high-risk patients.