Sentinel Lymph Node Biopsy Using CT Lymphography in T1T2N0 Tongue Cancer

Abstract

PURPOSE: Sentinel lymph node (SLN) biopsy is a standard surgical procedure in those with early-stage tongue cancer. Radioisotopes (RI) and a gamma probe are generally used to detect SLN, but RI can only be done at specialized institutions. SLN mapping with radiotracers is difficult if the SLN is close to the injection site because of shine-through radioactivity. We studied the utility of detecting SLN with computed tomography (CT) lymphography in those with tongue cancer. MATERIALS AND METHODS: Subjects numbered 12 with T1 or T2N0 tongue cancer. After 2 ml of iopamidol was injected peritumorally, CT was conducted at 1, 3, and 5 minutes after injection and SLN identified and marked on the day before surgery. SLN was examined pathohistologically by frozen section. RESULTS: SLN was identified in all but one case. SLN metastasis was found in one case each of T2N0 and T1N0. CONCLUSION: CT lymphography in SLN detection of tongue cancer is simple and useful because the anatomical relationship of tumors, lymphvessels, and SLN could be determined preoperatively.