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Published in: European Radiology 11/2020

01-11-2020 | Computed Tomography | Experimental

Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media in microminipig: imaging protocol and feasibility

Authors: Yukichi Tanahashi, Ryota Iwasaki, Shinichi Shoda, Hiroshi Kawada, Tomohiro Ando, Masaki Takasu, Fuminori Hyodo, Satoshi Goshima, Takashi Mori, Masayuki Matsuo

Published in: European Radiology | Issue 11/2020

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Abstract

Objectives

To evaluate the optimal imaging protocol and the feasibility of intranodal dynamic contrast-enhanced computed tomography lymphangiography (DCCTL) in microminipigs.

Methods

The Committee for Animal Research and Welfare provided university approval. Five female microminipigs underwent DCCTL after inguinal lymph node injection of 0.1 mL/kg of iodine contrast media at a rate of 0.3 mL/min with three different iodine concentrations: group 1, 75 mgI/mL; group 2, 150 mgI/mL; and group 3, 300 mgI/mL. The CT values of the venous angle, thoracic duct (TD), cisterna chyli, iliac lymphatic duct, and iliac lymph node were measured; increases in CT values pre- to post-contrast were assessed as the contrast-enhanced index (CEI). Multi-detector row CT (MDCT) and volume rendering images showing the highest CEI were qualitatively evaluated.

Results

The CEI of all lymphatics peaked at 5–10 min. The mean CEI of TD at 10 min of group 2 (193.0 HU) and group 3 (201.5 HU) were significantly higher than that of group 1 (70.7 HU) (p = 0.024). The continuity and overall diagnostic acceptability of all lymphatic system components were better in group 3 (3.6 and 3.0, respectively) than group 1 (2.6 and 1.6) and group 2 (3.0 and 2.6) (p = 0.249 and 0.204).

Conclusions

The optimal imaging protocol for intranodal DCCTL could be dual-phase imaging at 5 and 10 min after the injection of 300 mgI/mL iodinated contrast media. DCCTL provided good images of lymphatics and is potentially feasible in clinical settings.

Key Points

• Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media showed the highest enhancement of all lymphatics at scan delays of 5 and 10 min.
• The optimal iodine concentration for intranodal dynamic contrast-enhanced computed tomography lymphangiography might be 300 mgI/mL.
• Intranodal dynamic contrast-enhanced computed tomography lymphangiography provided good images of all the lymphatic system components and is potentially feasible in clinical settings.
Literature
1.
go back to reference Hsu MC, Itkin M (2016) Lymphatic anatomy. Tech Vasc Interv Radiol 19:247–254CrossRef Hsu MC, Itkin M (2016) Lymphatic anatomy. Tech Vasc Interv Radiol 19:247–254CrossRef
2.
go back to reference Lv S, Wang Q, Zhao W et al (2017) A review of the postoperative lymphatic leakage. Oncotarget 8:69062–69075CrossRef Lv S, Wang Q, Zhao W et al (2017) A review of the postoperative lymphatic leakage. Oncotarget 8:69062–69075CrossRef
3.
go back to reference Matsumoto T, Yamagami T, Kato T et al (2009) The effectiveness of lymphangiography as a treatment method for various chyle leakages. Br J Radiol 82:286–290CrossRef Matsumoto T, Yamagami T, Kato T et al (2009) The effectiveness of lymphangiography as a treatment method for various chyle leakages. Br J Radiol 82:286–290CrossRef
4.
go back to reference Kawasaki R, Sugimoto K, Fujii M et al (2013) Therapeutic effectiveness of diagnostic lymphangiography for refractory postoperative chylothorax and chylous ascites: correlation with radiologic findings and preceding medical treatment. AJR Am J Roentgenol 201:659–666CrossRef Kawasaki R, Sugimoto K, Fujii M et al (2013) Therapeutic effectiveness of diagnostic lymphangiography for refractory postoperative chylothorax and chylous ascites: correlation with radiologic findings and preceding medical treatment. AJR Am J Roentgenol 201:659–666CrossRef
5.
go back to reference Dori Y, Zviman MM, Itkin M (2014) Dynamic contrast-enhanced MR lymphangiography: feasibility study in swine. Radiology 273:410–416CrossRef Dori Y, Zviman MM, Itkin M (2014) Dynamic contrast-enhanced MR lymphangiography: feasibility study in swine. Radiology 273:410–416CrossRef
6.
go back to reference Krishnamurthy R, Hernandez A, Kavuk S, Annam A, Pimpalwar S (2015) Imaging the central conducting lymphatics: initial experience with dynamic MR lymphangiography. Radiology 274:871–878CrossRef Krishnamurthy R, Hernandez A, Kavuk S, Annam A, Pimpalwar S (2015) Imaging the central conducting lymphatics: initial experience with dynamic MR lymphangiography. Radiology 274:871–878CrossRef
7.
go back to reference Nadolski GJ, Ponce-Dorrego MD, Darge K, Biko DM, Itkin M (2018) Validation of the position of injection needles with contrast-enhanced ultrasound for dynamic contract-enhanced MR lymphangiography. J Vasc Interv Radiol 29:1028–1030CrossRef Nadolski GJ, Ponce-Dorrego MD, Darge K, Biko DM, Itkin M (2018) Validation of the position of injection needles with contrast-enhanced ultrasound for dynamic contract-enhanced MR lymphangiography. J Vasc Interv Radiol 29:1028–1030CrossRef
8.
go back to reference Pimpalwar S, Chinnadurai P, Chau A et al (2018) Dynamic contrast enhanced magnetic resonance lymphangiography: categorization of imaging findings and correlation with patient management. Eur J Radiol 101:129–135CrossRef Pimpalwar S, Chinnadurai P, Chau A et al (2018) Dynamic contrast enhanced magnetic resonance lymphangiography: categorization of imaging findings and correlation with patient management. Eur J Radiol 101:129–135CrossRef
9.
go back to reference Chick JFB, Nadolski GJ, Lanfranco AR, Haas A, Itkin M (2019) Dynamic contrast-enhanced magnetic resonance lymphangiography and percutaneous lymphatic embolization for the diagnosis and treatment of recurrent chyloptysis. J Vasc Interv Radiol 30:1135–1139CrossRef Chick JFB, Nadolski GJ, Lanfranco AR, Haas A, Itkin M (2019) Dynamic contrast-enhanced magnetic resonance lymphangiography and percutaneous lymphatic embolization for the diagnosis and treatment of recurrent chyloptysis. J Vasc Interv Radiol 30:1135–1139CrossRef
10.
go back to reference Iwanaga T, Tokunaga S, Momoi Y (2016) Thoracic duct lymphography by subcutaneous contrast agent injection in a dog with chylothorax. Open Vet J 6:238–241CrossRef Iwanaga T, Tokunaga S, Momoi Y (2016) Thoracic duct lymphography by subcutaneous contrast agent injection in a dog with chylothorax. Open Vet J 6:238–241CrossRef
11.
go back to reference Johnson EG, Wisner ER, Kyles A, Koehler C, Marks SL (2009) Computed tomographic lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg 38:361–367CrossRef Johnson EG, Wisner ER, Kyles A, Koehler C, Marks SL (2009) Computed tomographic lymphography of the thoracic duct by mesenteric lymph node injection. Vet Surg 38:361–367CrossRef
12.
go back to reference Kim M, Lee H, Lee N et al (2011) Ultrasound-guided mesenteric lymph node iohexol injection for thoracic duct computed tomographic lymphography in cats. Vet Radiol Ultrasound 52:302–305CrossRef Kim M, Lee H, Lee N et al (2011) Ultrasound-guided mesenteric lymph node iohexol injection for thoracic duct computed tomographic lymphography in cats. Vet Radiol Ultrasound 52:302–305CrossRef
13.
go back to reference Dong J, Xin J, Shen W et al (2018) Unipedal diagnostic lymphangiography followed by sequential CT examinations in patients with idiopathic chyluria: a retrospective study. AJR Am J Roentgenol 210:792–798CrossRef Dong J, Xin J, Shen W et al (2018) Unipedal diagnostic lymphangiography followed by sequential CT examinations in patients with idiopathic chyluria: a retrospective study. AJR Am J Roentgenol 210:792–798CrossRef
14.
go back to reference Takasu M, Maeda M, Almunia J, Nakamura K, Nishii N, Takashima S (2018) Response to estrus induction with abortion treatment in microminipigs on different days after insemination. J Reprod Dev 64:361–364CrossRef Takasu M, Maeda M, Almunia J, Nakamura K, Nishii N, Takashima S (2018) Response to estrus induction with abortion treatment in microminipigs on different days after insemination. J Reprod Dev 64:361–364CrossRef
15.
go back to reference Baek Y, Won JH, Kong TW et al (2016) Lymphatic leak occurring after surgical lymph node dissection: a preliminary study assessing the feasibility and outcome of lymphatic embolization. Cardiovasc Intervent Radiol 39:1728–1735CrossRef Baek Y, Won JH, Kong TW et al (2016) Lymphatic leak occurring after surgical lymph node dissection: a preliminary study assessing the feasibility and outcome of lymphatic embolization. Cardiovasc Intervent Radiol 39:1728–1735CrossRef
16.
go back to reference Alomari MH, Lillis A, Kerr C, Newburger JW, Quinonez L, Alomari AI (2019) The use of non-ionic contrast agent for lymphangiography and embolization of the thoracic duct. Cardiovasc Intervent Radiol 42:481–483CrossRef Alomari MH, Lillis A, Kerr C, Newburger JW, Quinonez L, Alomari AI (2019) The use of non-ionic contrast agent for lymphangiography and embolization of the thoracic duct. Cardiovasc Intervent Radiol 42:481–483CrossRef
17.
go back to reference Kariya S, Komemushi A, Nakatani M, Yoshida R, Kono Y, Tanigawa N (2014) Intranodal lymphangiogram: technical aspects and findings. Cardiovasc Intervent Radiol 37:1606–1610CrossRef Kariya S, Komemushi A, Nakatani M, Yoshida R, Kono Y, Tanigawa N (2014) Intranodal lymphangiogram: technical aspects and findings. Cardiovasc Intervent Radiol 37:1606–1610CrossRef
18.
go back to reference Inoue M, Nakatsuka S, Yashiro H et al (2016) Lymphatic intervention for various types of lymphorrhea: access and treatment. Radiographics 36:2199–2211CrossRef Inoue M, Nakatsuka S, Yashiro H et al (2016) Lymphatic intervention for various types of lymphorrhea: access and treatment. Radiographics 36:2199–2211CrossRef
19.
go back to reference Itkin M (2016) Lymphatic intervention techniques: look beyond thoracic duct embolization. J Vasc Interv Radiol 27:1187–1188CrossRef Itkin M (2016) Lymphatic intervention techniques: look beyond thoracic duct embolization. J Vasc Interv Radiol 27:1187–1188CrossRef
20.
go back to reference Takasawa C, Seiji K, Matsunaga K et al (2012) Properties of N-butyl cyanoacrylate-iodized oil mixtures for arterial embolization: in vitro and in vivo experiments. J Vasc Interv Radiol 23(1215–1221):e1211 Takasawa C, Seiji K, Matsunaga K et al (2012) Properties of N-butyl cyanoacrylate-iodized oil mixtures for arterial embolization: in vitro and in vivo experiments. J Vasc Interv Radiol 23(1215–1221):e1211
21.
go back to reference Wortman JR, Uyeda JW, Fulwadhva UP, Sodickson AD (2018) Dual-energy CT for abdominal and pelvic trauma. Radiographics 38:586–602CrossRef Wortman JR, Uyeda JW, Fulwadhva UP, Sodickson AD (2018) Dual-energy CT for abdominal and pelvic trauma. Radiographics 38:586–602CrossRef
Metadata
Title
Dynamic contrast-enhanced computed tomography lymphangiography with intranodal injection of water-soluble iodine contrast media in microminipig: imaging protocol and feasibility
Authors
Yukichi Tanahashi
Ryota Iwasaki
Shinichi Shoda
Hiroshi Kawada
Tomohiro Ando
Masaki Takasu
Fuminori Hyodo
Satoshi Goshima
Takashi Mori
Masayuki Matsuo
Publication date
01-11-2020
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-020-07031-0

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