Association between contrast-enhanced ultrasonography and histopathological findings of the metastatic lymph nodes of patients with head and neck cancer: A preliminary study

Oikawa,Shin‑Ichi; Shiga,Kiyoto; Saito,Daisuke; Katagiri,Katsunori; Ikeda,Aya; Tuchida,Kodai; Miyaguchi,Jun; Ishida,Kazuyuki; Sugai,Tamotsu

doi:10.3892/ol.2018.7835

Association between contrast-enhanced ultrasonography and histopathological findings of the metastatic lymph nodes of patients with head and neck cancer: A preliminary study

Authors:
- Shin‑Ichi Oikawa
- Kiyoto Shiga
- Daisuke Saito
- Katsunori Katagiri
- Aya Ikeda
- Kodai Tuchida
- Jun Miyaguchi
- Kazuyuki Ishida
- Tamotsu Sugai
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Affiliations: Department of Head and Neck Surgery, Iwate Medical University School of Medicine, Morioka, Iwate 020‑8505, Japan, Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Morioka, Iwate 020‑8505, Japan
Published online on: January 22, 2018 https://doi.org/10.3892/ol.2018.7835
Pages: 4171-4176
Copyright: © Oikawa et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to investigate the usefulness of contrast‑enhanced ultrasonography (CEUS) and a newly developed analysis software for the detection of microcapillary network distribution in lymph nodes of patients with head and neck cancer (HNC) by comparing the CEUS and histopathological findings. Patients that were diagnosed with HNC between February and September 2016 were enrolled. A total of five patients underwent resection of the primary tumor and neck dissection as their initial treatment. The cervical lymph nodes of these patients were analyzed by CEUS intraoperatively, and their surgical specimens were examined histopathologically. The patients were diagnosed using a combination of physical examination, computed tomography, magnetic resonance imaging and fluorodeoxyglucose‑positron emission tomography. For CEUS examination, the microbubble contrast agent Sonazoid™ was injected into a peripheral vein. Video images of the metastatic lymph nodes were captured, and these were subjected to analysis by a newly developed image‑analysis software. It was possible to perform intraoperative CEUS of metastatic lymph nodes and obtain accurate matched sections for histopathological examination. Hematoxylin and eosin and cluster of differentiation (CD)34 staining revealed that the software was able to accurately detect capillary vessels in metastatic lymph nodes. However, a number of perfusion deficits were observed in these lymph nodes. In conclusion, by using CEUS with the analysis software, the density and distribution of blood vessels in the metastatic lymph nodes of patients with HNC was revealed. Although the present study was limited and preliminary, it was concluded that this method may be useful to evaluate and to map the capillary vessels in the metastatic lymph nodes of patients with HNC.

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