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- Sniffing Out the Sentinel: A Multi-Tech Approach to Lymph Node Detection
Sniffing Out the Sentinel: A Multi-Tech Approach to Lymph Node Detection
Veterinary Surgery, 2025
Obi Veterinary Education
November 11, 2025
Griffin, L. R., Franz, M., Steffey, M. A., Kent, M. S., Mayhew, P. D., Culp, W. T. N.
Background
The study investigates the effectiveness of a combined preoperative and intraoperative approach to identify sentinel lymph nodes (SLNs) in veterinary patients. SLN identification is crucial for staging and treatment planning in oncologic surgeries, yet optimal methods for detection remain an area of ongoing research.
Methods
The researchers employed a dual-phase detection strategy using preoperative imaging and intraoperative mapping techniques. This included a combination of radiopharmaceuticals, contrast agents, and lymphatic tracers to enhance the accuracy of SLN localization in clinical cases.
Results
The combined approach successfully identified SLNs in a high percentage of cases, demonstrating improved precision over single-method detection. The findings suggest that integrating multiple techniques increases reliability and facilitates more accurate surgical planning for oncologic interventions.
Limitations
The study acknowledges potential variability in tracer uptake and imaging resolution, which may affect consistency in SLN detection. Additionally, the necessity for specialized equipment and expertise could limit widespread adoption in general veterinary practice.
Conclusions
A multimodal strategy for SLN identification enhances detection accuracy, potentially improving oncologic outcomes. Further studies are recommended to refine protocols and assess long-term clinical benefits.
Sentinel lymph node (SLN) mapping findings for dog 4 depicting a cranial deep cervical lymph node as sentinel via (A) preoperative indirect CT-lymphography, (B) in situ visible dye with methylene blue (MB), (C) in situ near-infrared (NIR) imaging with indocyanine green (ICG), (D) in situ NIR imaging with ICG overlaid on the visible light image, (E) ex vivo visible dye with MB, (F), ex vivo NIR imaging with ICG, and (G) ex vivo NIR imaging with ICG overlaid on the visible light image. (A) The yellow arrow depicts the SLN with contrast uptake. (B–D) Cranial is at the right of the image, the yellow arrow depicts the SLN, and the additional MB and ICG uptake is secondary to dispersion within the peritumoral tissues following injection.
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