Evaluation of Surgical Aid of Methylene Blue in Addition to Intraoperative Gamma Probe for Sentinel Lymph Node Extirpation in 116 Canine Mast Cell Tumors (2017–2022)

Author:

Gariboldi Elisa Maria1ORCID,Ubiali Alessandra1ORCID,Chiti Lavinia Elena12ORCID,Ferrari Roberta1ORCID,De Zani Donatella1ORCID,Zani Davide Danilo1ORCID,Grieco Valeria1ORCID,Giudice Chiara1ORCID,Recordati Camilla1ORCID,Stefanello Damiano1ORCID,Auletta Luigi1ORCID

Affiliation:

1. Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, 26900 Lodi, Italy

2. Clinic for Small Animals Surgery, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland

Abstract

Methylene Blue (MB) is combined with radiopharmaceutical for intraoperative sentinel lymph node (SLN) mapping, but its role during SLN extirpation has not been investigated yet in veterinary medicine. The aim of this study was to assess whether MB increased surgical detection of SLN beyond the use of intraoperative gamma-probe (IGP) alone in clinically node-negative dogs with mast cell tumors (MCTs) following the detection of sentinel lymphocentrums (SLCs) via preoperative planar lymphoscintigraphy. Dogs enrolled underwent MCT excision and SLC exploration guided by both MB and IGP. Data recorded for each SLN were staining (blue/non-blue), radioactivity (hot/non-hot), and histopathological status (HN0-1 vs. HN2-3). A total of 103 dogs bearing 80 cutaneous, 35 subcutaneous, and 1 mucocutaneous MCTs were included; 140 SLCs were explored, for a total of 196 SLNs removed. Associating MB with IGP raised the SLNs detection rate from 90% to 95%. A total of 44% of SLNs were metastatic: 86% were blue/hot, 7% were only blue, 5% were only hot, and 2% were non-blue/non-hot. All HN3 SLNs were hot. Combining MB with IGP can increase the rate of SLN detection in dogs with MCTs; nonetheless, all lymph nodes identified during dissection should be removed, as they might be unstained but metastatic.

Publisher

MDPI AG

Subject

General Veterinary,Animal Science and Zoology

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