Lymphatic drainage from the head and neck is variable with significant crossover, therefore sentinel lymph node (SLN) mapping can help ensure the appropriate lymph node(s) are sampled. To improve sensitivity, SLN mapping utilizing multiple modalities and a combination of preoperative computed tomography lymphography (CTL) and intraoperative near infrared fluorescence imaging (NIRF) with indocyanine green (ICG) +/− methylene blue (MB) dye has been suggested. The aim of this study was to describe a method for intraoperative ICG lymphography and determine agreement for SLN detection using preoperative CTL and intraoperative ICG NIRF + MB lymphography (IOL) in dogs with oral tumours. Fourteen client‐owned dogs were included. All dogs had preoperative CTL with iodinated contrast and intraoperative IOL with an exoscope. Lymph nodes with CTL contrast‐enhancement, blue staining or fluorescence were considered sentinel. The overall SLN identification rate was 100% when CTL and IOL were combined. A total of 57 SLNs were identified. Indocyanine green NIRF identified a greater proportion of SLNs (91%; 52/57) compared with MB (50.8%; 29/57) and CTL (42.1%; 24/57). Eighteen SLNs were identified by all three modalities with a fair level of agreement using Fleiss kappa. These findings suggest a combination of preoperative CTL with intraoperative SLN mapping techniques may greatly improve the ability to accurately detect the SLN in dogs with oral tumours.

中文翻译：

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确定术前计算机断层扫描淋巴造影和吲哚菁绿近红外荧光术中成像在口腔肿瘤犬前哨淋巴结标测中的一致性

头部和颈部的淋巴引流随显着交叉而变化，因此前哨淋巴结 (SLN) 标测有助于确保对适当的淋巴结进行采样。为了提高灵敏度，建议使用多种方式进行 SLN 映射，并结合术前计算机断层扫描淋巴造影 (CTL) 和术中近红外荧光成像 (NIRF) 与吲哚菁绿 (ICG) +/- 亚甲蓝 (MB) 染料。本研究的目的是描述一种术中 ICG 淋巴造影的方法，并确定在患有口腔肿瘤的狗中使用术前 CTL 和术中 ICG NIRF + MB 淋巴造影 (IOL) 检测 SLN 的一致性。包括 14 只客户拥有的狗。所有的狗都有术前 CTL 和碘对比剂，术中 IOL 有外窥镜。具有 CTL 对比增强、蓝色染色或荧光的淋巴结被认为是前哨淋巴结。当CTL和IOL结合时，总的SLN识别率为100%。共识别出 57 个 SLN。与 MB (50.8%; 29/57) 和 CTL (42.1%; 24/57) 相比，吲哚菁绿 NIRF 鉴定出更高比例的 SLN (91%; 52/57)。所有三种模式都使用 Fleiss kappa 确定了 18 个 SLN，并具有相当程度的一致性。这些发现表明，术前 CTL 与术中 SLN 标测技术的结合可以极大地提高准确检测患有口腔肿瘤的狗的 SLN 的能力。与 MB (50.8%; 29/57) 和 CTL (42.1%; 24/57) 相比，吲哚菁绿 NIRF 鉴定出更高比例的 SLN (91%; 52/57)。所有三种模式都使用 Fleiss kappa 确定了 18 个 SLN，并具有相当程度的一致性。这些发现表明，术前 CTL 与术中 SLN 标测技术的结合可以极大地提高准确检测患有口腔肿瘤的狗的 SLN 的能力。与 MB (50.8%; 29/57) 和 CTL (42.1%; 24/57) 相比，吲哚菁绿 NIRF 鉴定出更高比例的 SLN (91%; 52/57)。所有三种模式都使用 Fleiss kappa 确定了 18 个 SLN，并具有相当程度的一致性。这些发现表明，术前 CTL 与术中 SLN 标测技术的结合可以极大地提高准确检测患有口腔肿瘤的狗的 SLN 的能力。