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• W2019989803 abstract "1. IntroductionMetastases to local and distant lymph node play a major role in tumor staging, choice of therapy and in predicting outcome of malignant diseases [1Branagan G. Hughes D. Jeffrey M. Crane-Robinson C. Perry P.M. Detection of micrometastases in lymph nodes from patients with breast cancer.Br J Surg. 2002; 89: 86-89Crossref PubMed Scopus (32) Google Scholar, 2Carter C.L. Allen C. Henson D.E. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases.Cancer. 1989; 63: 181-187Crossref PubMed Google Scholar, 3Dowlatshahi K. Fan M. Snider H.C. Habib F.A. Lymph node micrometastases from breast carcinoma: reviewing the dilemma.Cancer. 1997; 80: 1188-1197Crossref PubMed Scopus (387) Google Scholar, 4Mussurakis S. Buckley D.L. Horsman A. Prediction of axillary lymph node status in invasive breast cancer with dynamic contrast-enhanced MR imaging.Radiology. 1997; 203: 317-321PubMed Google Scholar, 5Obwegeser R. Lorenz K. Hohlagschwandtner M. Czerwenka K. Schneider B. Kubista E. Axillary lymph nodes in breast cancer: is size related to metastatic involvement?.World J Surg. 2000; 24: 546-550Crossref PubMed Scopus (11) Google Scholar, 6Stets C. Brandt S. Wallis F. Buchmann J. Gilbert F.J. Heywang-Koebrunner S.H. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.J Magn Reson Imag. 2002; 16: 60-68Crossref PubMed Scopus (49) Google Scholar, 7Viale G. Maiorano E. Mazzarol G. et al.Histologic detection and clinical implications of micrometastases in axillary sentinel lymph nodes for patients with breast carcinoma.Cancer. 2001; 92: 1378-1384Crossref PubMed Scopus (182) Google Scholar, 8Weissleder R. Elizondo G. Josephson L. et al.Experimental lymph node metastases: enhanced detection with MR lymphography.Radiology. 1989; 171: 835-839PubMed Google Scholar, 9Harisinghani M.G. Barentsz J. Hahn P.F. Deserno W.M. Tabatabaei S. van de Kaa C.H. et al.Noninvasive detection of clinically occult lymph-node metastases in prostate cancer.N Engl J Med. 2003; 348: 2491-2499Crossref PubMed Scopus (1035) Google Scholar, 10Wunderbaldinger P. Weissleder R. Experimentelle und klinische Ansaetze zur Lymphknotenbildgebung.Radiologe. 2001; 41: 121-130Crossref PubMed Scopus (6) Google Scholar, 11Wunderbaldinger P. Josephson L. Bremer C. Moore A. Weissleder R. Detection of lymph node metastases by contrast enhanced MR imaging in an experimental model.Magn Reson Med. 2002; 47: 292-297Crossref PubMed Scopus (39) Google Scholar, 12Ozalp S. Yalcin O.T. Polay S. Aslan N. Vardareli E. Adapinar B. Diagnostic efficacy of the preoperative lymphoscintigraphy, Ga-67 scintigraphy and computed tomography for detection of lymph node metastasis in cases with ovarian or endometrial carcinoma.Acta Obstet Gynecol Scand. 1999; 78: 155-159Crossref PubMed Google Scholar, 13Kvistad K.A. Rydland J. Smethurst H.B. Lundgren S. Fjosne H.E. Haraldseth O. Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI.Eur Radiol. 2000; 10: 1464-1471Crossref PubMed Scopus (65) Google Scholar, 14Herreras-Oreales L. Justiniano J. Castillo N. Petrelli N.J. Stule J.P. Mittelman A. Metastases in small lymph nodes from colon cancer.Arch Surg. 1987; 122: 1253-1256Crossref PubMed Google Scholar, 15Gu C.-D. Osaki T. Oyama T. et al.Detection of micrometastatic tumor cells in pN0 lymph nodes of patients with completely resected nonsmall cell lung cancer—impact on recurrence and survival.Ann Surg. 2002; 235: 133-139Crossref PubMed Scopus (93) Google Scholar, 16Fultz P.J. Feins R.H. Strang J.G. et al.Detection and diagnosis of nonpalpable supraclavicular lymph nodes in lung cancer at CT and US.Radiology. 2002; 222: 245-251Crossref PubMed Google Scholar, 17Arita T. Matsumoto T. Kuramitsu T. et al.Is it possible to differentiate malignant from benign nodes by size?.Chest. 1996; 110: 1004-1008Crossref PubMed Google Scholar]. Several large scale clinical trials confirm the significant differences in mortality and morbidity in patients with occult micrometastases (per definition lymph node metastases with a diameter less than 2 mm) at time of diagnosis, a finding that furthermore justifies diligent lymph node mapping [1Branagan G. Hughes D. Jeffrey M. Crane-Robinson C. Perry P.M. Detection of micrometastases in lymph nodes from patients with breast cancer.Br J Surg. 2002; 89: 86-89Crossref PubMed Scopus (32) Google Scholar, 2Carter C.L. Allen C. Henson D.E. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases.Cancer. 1989; 63: 181-187Crossref PubMed Google Scholar, 3Dowlatshahi K. Fan M. Snider H.C. Habib F.A. Lymph node micrometastases from breast carcinoma: reviewing the dilemma.Cancer. 1997; 80: 1188-1197Crossref PubMed Scopus (387) Google Scholar, 7Viale G. Maiorano E. Mazzarol G. et al.Histologic detection and clinical implications of micrometastases in axillary sentinel lymph nodes for patients with breast carcinoma.Cancer. 2001; 92: 1378-1384Crossref PubMed Scopus (182) Google Scholar, 10Wunderbaldinger P. Weissleder R. Experimentelle und klinische Ansaetze zur Lymphknotenbildgebung.Radiologe. 2001; 41: 121-130Crossref PubMed Scopus (6) Google Scholar, 12Ozalp S. Yalcin O.T. Polay S. Aslan N. Vardareli E. Adapinar B. Diagnostic efficacy of the preoperative lymphoscintigraphy, Ga-67 scintigraphy and computed tomography for detection of lymph node metastasis in cases with ovarian or endometrial carcinoma.Acta Obstet Gynecol Scand. 1999; 78: 155-159Crossref PubMed Google Scholar, 14Herreras-Oreales L. Justiniano J. Castillo N. Petrelli N.J. Stule J.P. Mittelman A. Metastases in small lymph nodes from colon cancer.Arch Surg. 1987; 122: 1253-1256Crossref PubMed Google Scholar, 15Gu C.-D. Osaki T. Oyama T. et al.Detection of micrometastatic tumor cells in pN0 lymph nodes of patients with completely resected nonsmall cell lung cancer—impact on recurrence and survival.Ann Surg. 2002; 235: 133-139Crossref PubMed Scopus (93) Google Scholar, 16Fultz P.J. Feins R.H. Strang J.G. et al.Detection and diagnosis of nonpalpable supraclavicular lymph nodes in lung cancer at CT and US.Radiology. 2002; 222: 245-251Crossref PubMed Google Scholar, 17Arita T. Matsumoto T. Kuramitsu T. et al.Is it possible to differentiate malignant from benign nodes by size?.Chest. 1996; 110: 1004-1008Crossref PubMed Google Scholar]. With this in mind, routine use of adjuvant chemotherapy even in lymph node negative cancer patients has been accepted and shown to be effective [1Branagan G. Hughes D. Jeffrey M. Crane-Robinson C. Perry P.M. Detection of micrometastases in lymph nodes from patients with breast cancer.Br J Surg. 2002; 89: 86-89Crossref PubMed Scopus (32) Google Scholar, 2Carter C.L. Allen C. Henson D.E. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases.Cancer. 1989; 63: 181-187Crossref PubMed Google Scholar, 3Dowlatshahi K. Fan M. Snider H.C. Habib F.A. Lymph node micrometastases from breast carcinoma: reviewing the dilemma.Cancer. 1997; 80: 1188-1197Crossref PubMed Scopus (387) Google Scholar, 14Herreras-Oreales L. Justiniano J. Castillo N. Petrelli N.J. Stule J.P. Mittelman A. Metastases in small lymph nodes from colon cancer.Arch Surg. 1987; 122: 1253-1256Crossref PubMed Google Scholar, 17Arita T. Matsumoto T. Kuramitsu T. et al.Is it possible to differentiate malignant from benign nodes by size?.Chest. 1996; 110: 1004-1008Crossref PubMed Google Scholar]. However, the majority of these patients are thus overtreated with all risks, side effects and expense of adjuvant treatment. Clinical examination to detect lymph node metastases alone is inadequate and surgical dissection and serial histologic examination are currently accepted “yardsticks”. As has been shown invasive diagnosis is still regarded as the gold standard for establishing potential lymph node involvement, and has been the final basis for therapeutic decisions [1Branagan G. Hughes D. Jeffrey M. Crane-Robinson C. Perry P.M. Detection of micrometastases in lymph nodes from patients with breast cancer.Br J Surg. 2002; 89: 86-89Crossref PubMed Scopus (32) Google Scholar, 2Carter C.L. Allen C. Henson D.E. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases.Cancer. 1989; 63: 181-187Crossref PubMed Google Scholar, 3Dowlatshahi K. Fan M. Snider H.C. Habib F.A. Lymph node micrometastases from breast carcinoma: reviewing the dilemma.Cancer. 1997; 80: 1188-1197Crossref PubMed Scopus (387) Google Scholar, 4Mussurakis S. Buckley D.L. Horsman A. Prediction of axillary lymph node status in invasive breast cancer with dynamic contrast-enhanced MR imaging.Radiology. 1997; 203: 317-321PubMed Google Scholar, 5Obwegeser R. Lorenz K. Hohlagschwandtner M. Czerwenka K. Schneider B. Kubista E. Axillary lymph nodes in breast cancer: is size related to metastatic involvement?.World J Surg. 2000; 24: 546-550Crossref PubMed Scopus (11) Google Scholar, 6Stets C. Brandt S. Wallis F. Buchmann J. Gilbert F.J. Heywang-Koebrunner S.H. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.J Magn Reson Imag. 2002; 16: 60-68Crossref PubMed Scopus (49) Google Scholar, 7Viale G. Maiorano E. Mazzarol G. et al.Histologic detection and clinical implications of micrometastases in axillary sentinel lymph nodes for patients with breast carcinoma.Cancer. 2001; 92: 1378-1384Crossref PubMed Scopus (182) Google Scholar, 10Wunderbaldinger P. Weissleder R. Experimentelle und klinische Ansaetze zur Lymphknotenbildgebung.Radiologe. 2001; 41: 121-130Crossref PubMed Scopus (6) Google Scholar]. Although these invasive methods are efficient diagnostic tools, they are expensive, time consuming and bear a rather significant risk of complications such as, e.g., seroma formations, lymphedema, numbness, local cosmetic alterations, inflammations and may sometime even lead to life treating situations [2Carter C.L. Allen C. Henson D.E. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases.Cancer. 1989; 63: 181-187Crossref PubMed Google Scholar, 3Dowlatshahi K. Fan M. Snider H.C. Habib F.A. Lymph node micrometastases from breast carcinoma: reviewing the dilemma.Cancer. 1997; 80: 1188-1197Crossref PubMed Scopus (387) Google Scholar, 6Stets C. Brandt S. Wallis F. Buchmann J. Gilbert F.J. Heywang-Koebrunner S.H. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.J Magn Reson Imag. 2002; 16: 60-68Crossref PubMed Scopus (49) Google Scholar, 8Weissleder R. Elizondo G. Josephson L. et al.Experimental lymph node metastases: enhanced detection with MR lymphography.Radiology. 1989; 171: 835-839PubMed Google Scholar, 9Harisinghani M.G. Barentsz J. Hahn P.F. Deserno W.M. Tabatabaei S. van de Kaa C.H. et al.Noninvasive detection of clinically occult lymph-node metastases in prostate cancer.N Engl J Med. 2003; 348: 2491-2499Crossref PubMed Scopus (1035) Google Scholar, 10Wunderbaldinger P. Weissleder R. Experimentelle und klinische Ansaetze zur Lymphknotenbildgebung.Radiologe. 2001; 41: 121-130Crossref PubMed Scopus (6) Google Scholar, 18Bellin M.F. Roy C. Kinkel K. et al.Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles—initial clinical experience.Radiology. 1998; 207: 799-808PubMed Google Scholar, 19van den Brekel M.W. Castelijns J.A. Snow G.B. Imaging of cervical lymphadenopathy.Neuroimag Clin N Am. 1996; 6: 417-434PubMed Google Scholar]. Furthermore, it has been shown for breast cancer that up to 70% of patients in whom axillary dissection was performed for initial staging were histologically lymph node negative and, thus, retrospectively, did not justify the invasive and expensive diagnostic method used [1Branagan G. Hughes D. Jeffrey M. Crane-Robinson C. Perry P.M. Detection of micrometastases in lymph nodes from patients with breast cancer.Br J Surg. 2002; 89: 86-89Crossref PubMed Scopus (32) Google Scholar, 2Carter C.L. Allen C. Henson D.E. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases.Cancer. 1989; 63: 181-187Crossref PubMed Google Scholar, 3Dowlatshahi K. Fan M. Snider H.C. Habib F.A. Lymph node micrometastases from breast carcinoma: reviewing the dilemma.Cancer. 1997; 80: 1188-1197Crossref PubMed Scopus (387) Google Scholar, 4Mussurakis S. Buckley D.L. Horsman A. Prediction of axillary lymph node status in invasive breast cancer with dynamic contrast-enhanced MR imaging.Radiology. 1997; 203: 317-321PubMed Google Scholar, 5Obwegeser R. Lorenz K. Hohlagschwandtner M. Czerwenka K. Schneider B. Kubista E. Axillary lymph nodes in breast cancer: is size related to metastatic involvement?.World J Surg. 2000; 24: 546-550Crossref PubMed Scopus (11) Google Scholar, 6Stets C. Brandt S. Wallis F. Buchmann J. Gilbert F.J. Heywang-Koebrunner S.H. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.J Magn Reson Imag. 2002; 16: 60-68Crossref PubMed Scopus (49) Google Scholar, 7Viale G. Maiorano E. Mazzarol G. et al.Histologic detection and clinical implications of micrometastases in axillary sentinel lymph nodes for patients with breast carcinoma.Cancer. 2001; 92: 1378-1384Crossref PubMed Scopus (182) Google Scholar]. Therefore, interest has grown in noninvasive imaging techniques as alternative for assessing nodal status. Unfortunately most imaging methods showed rather low sensitivities (between 45 and 90%) in clinical trials. This is because they either rely mainly on insensitive morphological criterion, such as shape, density, number, dynamic enhancement, and size of lymph node (>10 mm) [4Mussurakis S. Buckley D.L. Horsman A. Prediction of axillary lymph node status in invasive breast cancer with dynamic contrast-enhanced MR imaging.Radiology. 1997; 203: 317-321PubMed Google Scholar, 6Stets C. Brandt S. Wallis F. Buchmann J. Gilbert F.J. Heywang-Koebrunner S.H. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.J Magn Reson Imag. 2002; 16: 60-68Crossref PubMed Scopus (49) Google Scholar, 8Weissleder R. Elizondo G. Josephson L. et al.Experimental lymph node metastases: enhanced detection with MR lymphography.Radiology. 1989; 171: 835-839PubMed Google Scholar, 9Harisinghani M.G. Barentsz J. Hahn P.F. Deserno W.M. Tabatabaei S. van de Kaa C.H. et al.Noninvasive detection of clinically occult lymph-node metastases in prostate cancer.N Engl J Med. 2003; 348: 2491-2499Crossref PubMed Scopus (1035) Google Scholar, 10Wunderbaldinger P. Weissleder R. Experimentelle und klinische Ansaetze zur Lymphknotenbildgebung.Radiologe. 2001; 41: 121-130Crossref PubMed Scopus (6) Google Scholar, 11Wunderbaldinger P. Josephson L. Bremer C. Moore A. Weissleder R. Detection of lymph node metastases by contrast enhanced MR imaging in an experimental model.Magn Reson Med. 2002; 47: 292-297Crossref PubMed Scopus (39) Google Scholar, 13Kvistad K.A. Rydland J. Smethurst H.B. Lundgren S. Fjosne H.E. Haraldseth O. Axillary lymph node metastases in breast cancer: preoperative detection with dynamic contrast-enhanced MRI.Eur Radiol. 2000; 10: 1464-1471Crossref PubMed Scopus (65) Google Scholar, 16Fultz P.J. Feins R.H. Strang J.G. et al.Detection and diagnosis of nonpalpable supraclavicular lymph nodes in lung cancer at CT and US.Radiology. 2002; 222: 245-251Crossref PubMed Google Scholar, 20Curtin H.D. Ishwaran H. Mancuso A.A. Dalley R.W. Caudry D.J. McNeil B.J. 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The disadvantage of size discrimination becomes evident, in patients with colon cancer, as it has been shown that the majority of lymph node metastases (e.g., 65% for colon cancer) measured less than 5 mm, whereas only 22% had diameters between 5 and 10 mm, and only 13% proved to be larger than 10 mm in size [[14]Herreras-Oreales L. Justiniano J. Castillo N. Petrelli N.J. Stule J.P. Mittelman A. Metastases in small lymph nodes from colon cancer.Arch Surg. 1987; 122: 1253-1256Crossref PubMed Google Scholar]. On the other hand, nuclear imaging methods such as PET, SPECT and colloid scintigraphy, although based on a functional/biological approach, proved to be inaccurate due to their poor spatial resolution and/or inadequate target-to-background signal [6Stets C. Brandt S. Wallis F. Buchmann J. Gilbert F.J. Heywang-Koebrunner S.H. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.J Magn Reson Imag. 2002; 16: 60-68Crossref PubMed Scopus (49) Google Scholar, 10Wunderbaldinger P. Weissleder R. Experimentelle und klinische Ansaetze zur Lymphknotenbildgebung.Radiologe. 2001; 41: 121-130Crossref PubMed Scopus (6) Google Scholar, 11Wunderbaldinger P. Josephson L. Bremer C. Moore A. Weissleder R. Detection of lymph node metastases by contrast enhanced MR imaging in an experimental model.Magn Reson Med. 2002; 47: 292-297Crossref PubMed Scopus (39) Google Scholar, 18Bellin M.F. Roy C. Kinkel K. et al.Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles—initial clinical experience.Radiology. 1998; 207: 799-808PubMed Google Scholar, 19van den Brekel M.W. Castelijns J.A. Snow G.B. Imaging of cervical lymphadenopathy.Neuroimag Clin N Am. 1996; 6: 417-434PubMed Google Scholar, 23Kernstine K.H. Stanford W. Mullan B.F. et al.PET, CT, and MRI with combidex for mediastinal staging in non-small cell lung carcinoma.Ann Thorac Surg. 1999; 68: 1022-1028Abstract Full Text Full Text PDF PubMed Scopus (89) Google Scholar, 32Sigal R. Vogl T. Casselman J. et al.Lymph node metastases from head and neck squamous cell carcinoma: MR imaging with ultrasmall superparamagnetic iron oxide particles (Sinerem MR)—results of a phase-III multicenter clinical trial.Eur Radiol. 2002; 12: 1104-1113Crossref PubMed Scopus (119) Google Scholar, 39Fischbein N.J. Noworolski S.M. Henry R.G. Kaplan M.J. Dillon W.P. Nelson S.J. Assessment of metastatic cervical adenopathy using dynamic contrast enhanced MR imaging.Am J Neuroradiol. 2003; 24: 301-311PubMed Google Scholar, 53Harisinghani M.G. Saini S. Weissleder R. et al.MR lymphangiography using ultrasmall superparamagnetic iron oxide in patients with primary abdominal and pelvic malignancies: radiographic–pathologic correlation.Am J Roentgenol. 1999; 172: 1347-1351Crossref PubMed Google Scholar, 54Castelijns J.A. van den Brekel M.W.M. Imaging of lymphadenopathy in the neck.Eur Radiol. 2002; 12: 727-738Crossref PubMed Scopus (83) Google Scholar, 55Bar-Shalom R. Valdivia A. Blaufox M. PET imaging in oncology.Semin Nucl Med. 2000; 30: 150-185Abstract Full Text PDF PubMed Google Scholar, 56Boiselle P. Patz E. Vining D. Weissleder R. Shepard J.-A. McLoud T. Imaging of mediastinal lymph nodes: CT, MR, and FDG PET.Radiographics. 1998; 18: 1061-1069Crossref PubMed Google Scholar].The lack of precise criteria to differentiate benign from metastatic nodes, together with inadequate sensitivity of current imaging techniques, warrants to increase diagnostic accuracy of noninvasive preoperative imaging modalities. Thus, the major challenge for imaging is to increase the specificity, to minimize the number of false positive results, which could influence therapeutic strategies and exclude major curative treatment. To enhance this point an overview of accuracy, specificity and sensitivity of several clinical and experimental studies using different imaging approaches for lymph node metastases detection is given in Table 1 [4Mussurakis S. Buckley D.L. Horsman A. Prediction of axillary lymph node status in invasive breast cancer with dynamic contrast-enhanced MR imaging.Radiology. 1997; 203: 317-321PubMed Google Scholar, 6Stets C. Brandt S. Wallis F. Buchmann J. Gilbert F.J. Heywang-Koebrunner S.H. Axillary lymph node metastases: a statistical analysis of various parameters in MRI with USPIO.J Magn Reson Imag. 2002; 16: 60-68Crossref PubMed Scopus (49) Google Scholar, 8Weissleder R. Elizondo G. 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• W2019989803 created "2016-06-24" @default.
• W2019989803 creator A5072543198 @default.
• W2019989803 date "2006-06-01" @default.
• W2019989803 modified "2023-09-25" @default.
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