Ultra-small superparamagnetic iron oxide particles enhance MRI diagnosis of lymph node metastasis of the head and neck

doi:10.3969/j.issn.2095-4344.0993

Abstract

Abstract:

BACKGROUND: Studies have shown that ultra-small superparamagnetic iron oxide particles (USPIO) enhanced scanning improves the specificity and sensitivity of malignant lymph node detection in pelvic, breast, and chest malignancies. However, USPIO is rarely reported in the literature addressing lymph node metastasis of the head and neck.

OBJECTIVE: To establish an animal model of lymph node metastasis of the head and neck, to analyze USPIO enhanced MRI performance of the lymph metastasis, and to explore the clinical value of USPIO in the lymph node metastasis of the head and neck.

METHODS: Animal models of lymph node metastasis of the head and neck were made in 20 healthy New Zealand rabbits. At 4 weeks after modeling, a plain MRI scan was performed. A novel MR contrast agent, USPIO, was injected into the rabbit ear vein at 90 μmol Fe/kg (about 4 mg/kg). MRI scan was performed before and 24 hours after injection. After scanning, the head and neck lymph nodes were taken out, and hematoxylin-eosin staining and Prussian blue staining were performed to determine the nature of lymph nodes. The characteristics of head and neck metastatic lymph nodes in different MRI examinations were qualitatively and quantitatively analyzed. MRI plain scan and USPIO enhanced scan were used to identify the ability of rabbit VX2 tumor metastasis and non-metastatic lymph nodes in the head and neck.

RESULTS AND CONCLUSION: (1) Fifty-seven lymph nodes were isolated from 20 rabbits, 25 of which were confirmed to be metastatic by pathological examination (19 parotid lymph nodes and 6 submandibular lymph nodes). Pathological findings confirmed cortex invasion in 4 metastatic lymph nodes, medullary infiltration in 3 metastatic lymph nodes, and cortex and medulla infiltration in 10 metastatic lymph nodes. (2) The plain MRI scan detected 13 metastatic lymph nodes were true positive and the positive rate was 52% (13/25);10 lymph nodes were false positive and the false-positive rate was 40% (10/25). MRI scans showed 34 lymph nodes without metastasis, and 32 pathology-negative lymph nodes. The true negative rate was 69% (22/32), and the false negative rate was 38% (12/32). (3) USPIO enhanced scan detected 21 metastatic lymph nodes that were confirmed pathologically. The true positive rate was 84% (21/25), and the false positive rate was 8% (2/25). MRI scans showed 34 lymph nodes without metastasis, and the true negative rate was 94% (30/32) and the false negative rate was 13% (4/32). (4) Quantitative analysis of lymph nodes without metastasis was as follows: △SNR=-57.20±16.03, and that of metastatic lymph nodes was as follows: △SNR=-16.20±5.03. △SNR values showed statistically significant differences before and after enhanced (P < 0.05). To conclude, USPIO enhanced MRI is a new method for the diagnosis of lymph node metastasis, and has high diagnostic accuracy compared with conventional MRI scan.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Tissue Engineering, Parotid Gland, Lymph Nodes

CLC Number:

R318

Li Wenjin, Niu Jinliang, Zhu Li, Wang Tao, Wang Yu. Ultra-small superparamagnetic iron oxide particles enhance MRI diagnosis of lymph node metastasis of the head and neck[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(34): 5518-5525.

Figures/Tables 3

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