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Purpose: To validate the usefulness of a newly developed tracer for preoperative gastric sentinel lymph node (LN) (SLN) mapping and intraoperative navigation after a single preoperative submucosal injection in rat and beagle models., Materials and Methods: This study was approved by the Experimental Animal Ethical Committee of Yonsei University College of Medicine according to the eighth edition of the Guide for the Care and Use of Laboratory Animals published in 2011. An emulsion was developed that contained indocyanine green in iodized oil, which can be visualized with both computed tomography (CT) and near-infrared (NIR) optical imaging and has the property of delayed washout. This emulsion was injected into the footpad of rats (n = 6) and the gastric submucosa of beagles (n = 8). CT lymphography was performed. The degree of enhancement of popliteal LNs was measured in rats, and the enhancing LNs were identified and the degree of enhancement of the enhancing LNs was measured in beagles. Next, NIR imaging was performed in beagles during open, laparoscopic, and robotic surgery to identify LNs containing the fluorescent signals of indocyanine green. The enhanced LNs detected with CT lymphography and NIR imaging were matched to see if they corresponded., Results: Preoperative CT lymphography facilitated SLN mapping, and 26 SLNs were identified in eight beagles. NIR imaging enabled high-spatial-resolution visualization of both SLNs and the intervening lymphatic vessels and was useful for intraoperative SLN navigation., Conclusion: SLN mapping with fluorescent iodized oil emulsion is effective and feasible for both CT and NIR imaging., (© RSNA, 2014 Online supplemental material is available for this article.)

Purpose: To evaluate the efficacy and safety of selective chemoembolization in patients with colorectal metastases to the liver., Materials and Methods: Forty-six patients underwent the regimen, which involved use of doxorubicin and ethiodized oil, with 75% selectively administered to different subsegments and 25% into the respective main hepatic artery., Results: In eight patients, the lesions disappeared and carcinoembryonic antigen levels returned to normal. Eleven patients showed no disease progression for 12 months; two others, for 24 months. Thirteen patients died; three were lost to follow-up in the 1st year. Six patients were followed up for 5 years, seven for 3 years, 16 for 2 years, and 30 for 1 year. Five of seven patients who survived 3 years or more exhibited homogeneous distribution of the chemoembolic agent throughout the metastatic tumor., Conclusion: Selective chemoembolization is recommended for treatment of patients with colorectal metastases to the liver, a resectable primary tumor, and no evidence of other metastatic disease.