Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Oblique view of preoperative lymphoscintigraphy improves detection of sentinel lymph nodes in esophageal cancer

  • 48 Accesses

  • 3 Citations


Because sentinel lymph nodes (SLNs) of esophageal cancer can be widely located between the neck and the upper abdomen, lymphoscintigraphy plays an important role in their detection, but some modifications are required to clearly visualize their locations. Recently, we applied the stereoscopic imaging method by adding the 10-degree oblique view to the conventional lymphoscintigraphy for SLNs, so that we could better determine SLN locations on the basis of depth information. In this report, we describe a case in which the oblique view of the lymphoscintigram contributed to improving the visualization of a mediastinal SLN of esophageal cancer. Evaluation of the patient’s chest CT image validated the notion that gamma rays from SLN are less absorbed by the surrounding soft tissues and the sternum in acquisition from the oblique view than from the true anterior view. The additional oblique view of the lymphoscintigram is useful for evaluation of the SLNs of esophageal cancer.

This is a preview of subscription content, log in to check access.


  1. 1.

    Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, et al. Technical details of intraoperative lymphatic mapping for early stage melanoma.Arch Surg 1992; 127:392–399.

  2. 2.

    Krag DN, Weaver DL, Alex JC, Fairbank JT. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe.Surg Oncol 1993; 2:335–339.

  3. 3.

    Giuliano AE, Kirgan DM, Guenther JM, Morton DL. Lymphatic mapping and sentinel lymphadenectomy for breast cancer.Ann Surg 1994; 220:391–398.

  4. 4.

    Kitagawa Y, Kitajima M. Gastrointestinal cancer and sentinel node navigation surgery.J Surg Oncol 2002; 79:188–193.

  5. 5.

    Natsugoe S, Mueller J, Stein HJ, Feith M, Hofler H, Siewert JR. Micrometastasis and tumor cell microinvolvement of lymph nodes from esophageal squamous cell carcinoma: frequency, associated tumor characteristics, and impact on prognosis.Cancer 1998; 83:858–866.

  6. 6.

    Saha S, Dan AG, Bilchik AJ, Kitagawa Y, Schochet E, Choudhri S, et al. Historical review of lymphatic mapping in gastrointestinal malignancies.Ann Surg Oncol 2004; 11 3 Suppl):245S-249S.

  7. 7.

    Kuge K, Murakami G, Mizobuchi S, Hata Y, Aikou T, Sasaguri S. Submucosal territory of the direct lymphatic drainage system to the thoracic duct in the human esophagus.J Thorac Cardiovasc Surg 2003; 125:1343–1349.

  8. 8.

    Kitagawa Y, Fujii H, Mukai M, Kubo A, Kitajima M. Current status and future prospects of sentinel node navigational surgery for gastrointestinal cancers.Ann Surg Oncol 2004; 11 3 Suppl):242S-244S.

  9. 9.

    Hearn D, Baker MP.Computer Graphics, 2nd ed. Prentice Hall, Inc., Eaglewood Cliffs, New Jersey, 1994.

  10. 10.

    Kitagawa Y, Fujii H, Mukai M, Kubota T, Ando N, Ozawa S, et al. Intraoperative lymphatic mapping and sentinel lymph node sampling in esophageal and gastric cancer.Surg Oncol Clin N Am 2002; 11:293–304.

  11. 11.

    Fujii H, Kitagawa Y, Kitajima M, Kubo A. Sentinel nodes of malignancies originating in the alimentary tract.Ann Nucl Med 2004; 18:1–12.

  12. 12.

    Fujii H, Ikeda T, Jinno H, Kitagawa Y, Yamashita H, Seki S, et al. Lymphoscintigraphy for the visualization of sentinel lymph nodes and body contour.Breast Cancer 2004; 11:250–255.

  13. 13.

    Orringer MB. Occult cervical nodal metastases in esophageal cancer: preliminary results of three-field lymphadenectomy.J Thorac Cardiovasc Surg 1997; 113:538–539.

  14. 14.

    Altorki NK, Skinner DB. Occult cervical nodal metastasis in esophageal cancer: preliminary results of three-field lymphadenectomy.J Thorac Cardiovasc Surg 1997; 113:540–544.

Download references

Author information

Correspondence to Chikako Tanaka or Tadaki Nakahara or Takayuki Suzuki or Yuzuru Tanami or Atsushi Kubo or Hirofumi Fujii or Yuko Kitagawa or Masaki Kitajima or Yutaka Ando.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Tanaka, C., Nakahara, T., Suzuki, T. et al. Oblique view of preoperative lymphoscintigraphy improves detection of sentinel lymph nodes in esophageal cancer. Ann Nucl Med 19, 719 (2005).

Download citation

Key words

  • esophageal cancer
  • sentinel lymph node
  • lymphoscintigraphy
  • stereoscopic imaging
  • oblique view