Lymphoscintigraphy with radio-colloidal agent

• Project/Area Number: 17591970
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Pathobiological dentistry/Dental radiology
• Research Institution: Kagoshima University
• Principal Investigator: SATO Tsuyoshi Kagoshima University, Graduate School of Medical and Dental Sciences, Associate Professor, 大学院医歯学総合研究科, 助教授 (90136888)
• Co-Investigator(Kenkyū-buntansha): KAWABATA Yoshihiro Kagoshima University, Medical and Dental Hospital, Research Associate, 医学部・歯学部附属病院, 助手 (70274842) ; MAJIMA Hideyuki Kagoshima University, Graduate School of Medical and Dental Sciences, Professor, 大学院医歯学総合研究科, 教授 (60165701) ; KAWASHIMA Kiyomi Kagoshima University, Medical and Dental Hospital, Assistant Professor, 医学部・歯学部附属病院, 講師 (40145511) ; YAMAGUCHI Koujirou Kagoshima University, Graduate School of Medical and Dental Sciences, Research Associate, 大学院医歯学総合研究科, 助手 (00210360) ; NOZOE Etsurou Kagoshima University, Graduate School of Medical and Dental Sciences, Associate Professor, 大学院医歯学総合研究科, 助教授 (40208351)
• Project Period (FY): 2005 – 2006
• Project Status: Completed (Fiscal Year 2006)
• Budget Amount: ¥3,500,000 (Direct Cost: ¥3,500,000); Fiscal Year 2006: ¥700,000 (Direct Cost: ¥700,000); Fiscal Year 2005: ¥2,800,000 (Direct Cost: ¥2,800,000)
• Keywords: lymph node / scintigram / radio-colloid / PET / 悪性腫瘍

Research Abstract

(Materials ＆ Methods) Patients with oral cancer were examined by the scintigraphy with Tc-radio-colloid and PET with FDG. To detect lymph node metastasis, lymphoscintigraphy and PET scan were performed. In lymphoscintigraphy, two areas of injection were selected. One is the extra-oral subcutaneous area behind the ear for the cervical lymph nodes. The other is the intra-oral sub mucosal area of mucobuccal fold of the upper molar region for the submandibular lymph nodes. The radio-colloid in each volume of 0.25 ml (37MBq) was injected in both sides of each area respectively. Scanning was done immediately after injection with Gamma camera. In PET, FDG of 3.7MBq/kg was injected intravenously and the scanning was done after 40 min from the injection. Furthermore, the tumor samples, obtained either after the biopsy or after the operation, were embedded in paraffin wax and cut into thin sections for the immunohistochemical staining of the glucose transpototer. The accumulation of the lymph no des was evaluated into three groups and in PET scanning was evaluated into three grades respectively. The immunohistochemical staining was also evaluated into three grades visually. (Results) In PET scanning, around 75% of metastatic lymph nodes were detected. But, the detection strongly depended upon the size of lymph nodes and small lymph nodes were hardly detected (under 5%). The SUV ranged from 2 to 6 among lymph nodes and distributed widely. In lymphoscintigraphy, metastatic lymph nodes showed three images of defect, mottled and rope-like appearances. These images showed a close correlation with the pathologic manifestations respectively. In immunohistochemical staining of the glucose transporter, all metastatic lymph nodes showed from a moderate to a severe staining. (Conclusions) Lymphoscintigraphy with radio-colloida: agent and PET scanning with FDG were useful for the detection of metastatic lymph nodes of relatively large size. However, these methods were helpless for the small metastatic lymph nodes. Therefore, we will make a further evaluation to establish a technique for the detection of the small metastatic lymph nodes.