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Alvarez-Sanchez et al: Comparison of indirect computed tomographic lymphography and near-infrared fluorescence sentinel lymph node mapping for integumentary canine mast cell tumors
Veterinary Surgery 3, 2023

🔍 Key Findings

  • Combined ICTL and NIRF detected the same SLN in 80% of cases; each method alone missed sentinel lymph nodes in some dogs.
  • ICLT failed in 5% of dogs, while NIRF failed in 20%; combined use resulted in only 5% failure in SLN detection.
  • Metastatic lymph nodes were detected in 95% of dogs, despite most tumors being low or intermediate grade (95%).
  • 27 of 41 nodes (65.8%) were histologically metastatic (HN2 or HN3), many of which would have been missed using ALN alone.
  • ALN matched the SLN in only 45% of cases with ICTL and 30% with NIRF, supporting the need for SLN mapping.
  • ICLT and NIRF were complementary, often identifying different SLN, with some only fluorescent or enhanced in one modality.
  • Subcutaneous MCT had higher metastatic rates (7/8 dogs) than previously reported, challenging older assumptions about benign behavior.
  • Removing both ALN and SLN (from both methods) improved detection of metastasis to 85–95%, reducing risk of understaging.

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← Articles

Alvarez-Sanchez et al: Comparison of indirect computed tomographic lymphography and near-infrared fluorescence sentinel lymph node mapping for integumentary canine mast cell tumors
Veterinary Surgery 3, 2023

🔍 Key Findings

  • Combined ICTL and NIRF detected the same SLN in 80% of cases; each method alone missed sentinel lymph nodes in some dogs.
  • ICLT failed in 5% of dogs, while NIRF failed in 20%; combined use resulted in only 5% failure in SLN detection.
  • Metastatic lymph nodes were detected in 95% of dogs, despite most tumors being low or intermediate grade (95%).
  • 27 of 41 nodes (65.8%) were histologically metastatic (HN2 or HN3), many of which would have been missed using ALN alone.
  • ALN matched the SLN in only 45% of cases with ICTL and 30% with NIRF, supporting the need for SLN mapping.
  • ICLT and NIRF were complementary, often identifying different SLN, with some only fluorescent or enhanced in one modality.
  • Subcutaneous MCT had higher metastatic rates (7/8 dogs) than previously reported, challenging older assumptions about benign behavior.
  • Removing both ALN and SLN (from both methods) improved detection of metastasis to 85–95%, reducing risk of understaging.

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Multiple Choice Questions on this study

In Alvarez-Sanchez 2023 et al., on SLN mapping in canine MCT, what percentage of dogs had the same SLN identified by both ICTL and NIRF?

A. 40%
B. 55%
C. 65%
D. 80%
E. 95%

Answer: 80%

Explanation: ICLT and NIRF identified the same sentinel node in 80% of dogs, showing strong concordance when both methods were used together.
In Alvarez-Sanchez 2023 et al., on SLN mapping in canine MCT, which tumor type showed unexpectedly high rates of lymph node metastasis?

A. Visceral hemangiosarcoma
B. Cutaneous histiocytoma
C. Subcutaneous mast cell tumor
D. Squamous cell carcinoma
E. Soft tissue sarcoma

Answer: Subcutaneous mast cell tumor

Explanation: 7 of 8 dogs with subcutaneous MCT had metastatic nodes, challenging assumptions of benign behavior in this tumor subtype.
In Alvarez-Sanchez 2023 et al., on SLN mapping in canine MCT, which SLN detection method had the higher failure rate?

A. Near-infrared fluorescence (NIRF)
B. Indirect computed tomographic lymphography (ICTL)
C. Fine-needle aspiration cytology
D. Ultrasound-guided mapping
E. ALN biopsy alone

Answer: Near-infrared fluorescence (NIRF)

Explanation: NIRF failed in 20% of dogs, while ICTL failed in only 5%, making NIRF the less sensitive method individually.
In Alvarez-Sanchez 2023 et al., on SLN mapping in canine MCT, what was the histologic metastasis rate (HN2 or HN3) in excised lymph nodes?

A. 32%
B. 50%
C. 65.8%
D. 80%
E. 90%

Answer: 65.8%

Explanation: 27 of 41 excised lymph nodes were histologically metastatic, a high rate even though most tumors were low-to-intermediate grade.
In Alvarez-Sanchez 2023 et al., on SLN mapping in canine MCT, how often did the anatomic lymph node (ALN) match the SLN identified by ICTL?

A. 25%
B. 30%
C. 45%
D. 60%
E. 75%

Answer: 45%

Explanation: Only 45% of ALNs matched the ICTL-identified SLNs, indicating a high likelihood of misclassification when relying on anatomy alone.

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