Development of sentinel lymph node navigation system for superficial esophageal cancer

2013 Fiscal Year Final Research Report

• Project/Area Number: 23591936
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: The University of Tokushima
• Principal Investigator: KAWAKAMI Yukikiyo 徳島大学, 大学病院, 特任講師 (00596249)
• Co-Investigator(Kenkyū-buntansha): TANGOKU Akira 徳島大学, 大学院ヘルスバイオサイエンス研究部, 教授 (10197593) ; FURUKITA Yoshihito 徳島大学, 大学病院, 助教 (20563810) ; YOSHIDA Takahiro 徳島大学, 大学病院, 助教 (00380105) ; YAMAMOTO Yota 徳島大学, 大学病院, 助教 (50522273)
• Project Period (FY): 2011 – 2013
• Keywords: 食道癌 / 表在癌 / リンパ節転移 / センチネルリンパ節 / バイオイメージング

Research Abstract

This study evaluated the feasibility of sentinel lymph (SLN) node navigation using computed tomographic lymphography (CTLG) to treat superficial esophageal cancer. Forty-one patients clinically diagnosed with superficial esophageal cancer were entried after a written informed consent. After endoscopic submucosal injection of iopamidol around the primary lesion with a sclerotherapy needle, three-dimensional multidetector CT image was made to identify SLNs with their lymphatic routes. Fluorescence imaging was obtained by infrared ray electronic endoscopy after peri-tumor injection of ICG solution intraoperatively. Thoracoscope-assisted radical esophagectomy with lymphadenectomy was performed to confirm an accuracy of navigation. Lymphatic vessels and SLNs were identified preoperatively using CTLG and ICG fluorescent imaging in all cases. Lymph node metastases were found in 7 cases, including 5 micro metastases. The bulky metastatic tumor was diagnosed with CTLG by negative enhancement.

Research Products

• [Journal Article] Sentinel lymph node biopsy using intraoperative indocyanine green fluorescence imaging navigated with preoperative CT lymphography for superficial esophageal cancer (2012)
  • Author(s): Yuasa Y, Seike J, Yoshida T, Takechi H, Yamai H, Yamamoto Y, Furukita Y, Goto M, Minato T, Nishino T, Inoue S, fujiwara S, Tangoku A.
  • Journal Title: Annals of Surgical Oncology Volume: 19巻(2) Pages: 486-493
  • Peer Reviewed
• [Journal Article] The new era of staging as a key for an appropriate treatment for esophageal cancer (2012)
  • Author(s): Tangoku A, Yamamoto Y, Furukita Y, Goto M, Morimoto M.
  • Journal Title: Ann Thorac Cardiovasc Surg Volume: 18巻(3) Pages: 190-199
  • Peer Reviewed
• [Journal Article] Computed tomography lymphography by transbronchial injection of iopamidol to identify sentinel nodes in preoperative patients with non-small cell lung cancer : A pilot study (2012)
  • Author(s): Takizawa H, Kondo K, Toba H, Kajiura K, Abdellah Hamed Khalil Ali, Sakiyama S, Tangoku A.
  • Journal Title: J Thorac Cardiovasc Surg Volume: 144巻(1) Pages: 94-99
  • Peer Reviewed
• [Presentation] 3D-CT navigation surgery for superficial esophageal cancer (2013)
  • Author(s): Akira Tangoku
  • Organizer: International Surgical Week 2013
  • Place of Presentation: Helsinki Exihibition and Convention Center, Finland
  • Year and Date: 20130825-28
• [Presentation] SLN biopsy using intraoperative ICG fluorescence imaging navigation with preoperative CT lymphography for superficial esophageal cancer (2012)
  • Author(s): Akira Tangoku
  • Organizer: 13rd World Congress of the International Society for Diseases of the Esophagus
  • Place of Presentation: Venice Lido Congress Center, Italy
  • Year and Date: 20121015-17