Head and Neck

Contrast-Enhanced Ultrasound With Perflubutane for Sentinel Lymph Node Mapping in Cutaneous Melanoma: A Pilot Study

Corresponding Author

Caitlin Bertelsen MD

[email protected]

orcid.org/0000-0001-9118-0817

USC Caruso Department of Otolaryngology–Head and Neck Surgery, Los Angeles

Send correspondence to Caitlin Bertelsen, MD, Resident Physician, USC Keck School of Medicine, Caruso Department of Otolaryngology–Head and Neck Surgery, 1540 Alcazar Street, Suite 204, Los Angeles, CA 90033. E-mail: [email protected].Search for more papers by this author

Kevin G. King MD,

Kevin G. King MD

Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles

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Mark Swanson MD,

Mark Swanson MD

orcid.org/0000-0002-6140-0935

USC Caruso Department of Otolaryngology–Head and Neck Surgery, Los Angeles

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Vinay Duddalwar MD,

Vinay Duddalwar MD

Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles

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Jon-Paul Pepper MD,

Jon-Paul Pepper MD

Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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Caitlin Bertelsen MD,

Corresponding Author

Caitlin Bertelsen MD

[email protected]

orcid.org/0000-0001-9118-0817

USC Caruso Department of Otolaryngology–Head and Neck Surgery, Los Angeles

Kevin G. King MD,

Kevin G. King MD

Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles

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Mark Swanson MD,

Mark Swanson MD

orcid.org/0000-0002-6140-0935

USC Caruso Department of Otolaryngology–Head and Neck Surgery, Los Angeles

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Vinay Duddalwar MD,

Vinay Duddalwar MD

Department of Radiology, Keck School of Medicine of the University of Southern California, Los Angeles

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Jon-Paul Pepper MD,

Jon-Paul Pepper MD

Department of Otolaryngology–Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, U.S.A.

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First published: 03 October 2018

https://doi.org/10.1002/lary.27397

Citations: 9

Presented as a poster presentation at the Academy of Otolaryngology–Head and Neck Surgery Annual Meeting, Chicago, Illinois, U.S.A., September 11, 2017.

This study was sponsored by a grant awarded by the Wright Foundation to Dr. Kevin G. King, MD. The perflubutane contrast agent (sonazoid) was provided free of charge by General Electric Healthcare. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objective

To study the feasibility of contrast-enhanced ultrasound (CEUS) for identification of SLN associated with cutaneous melanoma.

Study Design

Single arm pilot study in a swine animal model.

Methods

One milliliter of perflubutane (Sonazoid, GE Healthcare, Milwaukee, WI) was injected into the peritumoral dermis in five swine with cutaneous melanoma. Ultrasonography was used to follow enhancing lymphatic channels to lymph nodes (LN). Intradermal injection of vital blue (VB) dye was used as a positive control. LN identified by either method were excised and examined histologically.

Results

There were five primary cutaneous melanomas with mean area of 4.36 ± 4.75 cm² and Breslow depth of 3.6 ± 1.5 mm. Six possible sentinel lymph node (SLN)s were identified with CEUS, and nine were identified with VB. SLN averaged 12.44 ± 6.15 cm from the primary tumor. Four of six (67%) SLNs identified by CEUS and four of nine (44%) candidate SLNs identified by VB contained histologically confirmed metastatic melanoma. All six CEUS-identified SLNs were also identified with VB. Two LNs not containing melanoma were identified by CEUS; three were identified with VB. In all SLN with metastases, metastatic cells were scattered throughout the LN and not clustered in a discrete mass.

Conclusion

CEUS with perflubutane feasibly identifies SLN associated with cutaneous melanoma and may be a useful adjunct technology in facilitating precise SLN dissection. Our work supports a clinical trial investigating the use of CEUS for this application.

Level of Evidence

NA Laryngoscope, 129:1117–1122, 2019

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Citing Literature

Volume129, Issue5

May 2019

Pages 1117-1122

Contrast-Enhanced Ultrasound With Perflubutane for Sentinel Lymph Node Mapping in Cutaneous Melanoma: A Pilot Study

Abstract

Objective

Study Design

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Contrast-Enhanced Ultrasound With Perflubutane for Sentinel Lymph Node Mapping in Cutaneous Melanoma: A Pilot Study

Abstract

Objective

Study Design

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

Information