Background: The purpose of this study was to evaluate the feasibility of MR lymphography with interstitial injection of a gadolinium-based contrast agent for identifying sentinel lymph nodes in patients with oral cavity cancer and clinically negative neck. Methods: Pretreatment MR lymphography with a differential subsampling with cartesian ordering (DISCO) sequence was performed in 26 patients with resectable oral cavity cancer and clinically negative neck, after peritumoral injection of 1-mL diluted gadobutrol. The accuracy of sentinel lymph node identification by MR lymphography was assessed and compared with the final histopathological results. Results: The MR lymphography consistently visualized the 44 sentinel lymph nodes in all 26 patients. In all but 1 patient with pathologically positive neck, assumed sentinel lymph nodes revealed metastatic involvement. Conclusion: Pretreatment MR lymphography is a safe and feasible imaging technique that can help clinicians identify sentinel lymph nodes with a high risk of occult metastases in patients with oral cavity cancer, enabling focused preoperative biopsy in these high-risk patients.
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