{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:58:40Z","timestamp":1788868720611,"version":"build-2803163510"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T00:00:00Z","timestamp":1763164800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004622","name":"KWF Kankerbestrijding","doi-asserted-by":"publisher","award":["2021-2 \/ 14109"],"award-info":[{"award-number":["2021-2 \/ 14109"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017246","name":"Radboud Institute for Health Sciences","doi-asserted-by":"publisher","award":["Junior Research Grant 2017"],"award-info":[{"award-number":["Junior Research Grant 2017"]}],"id":[{"id":"10.13039\/501100017246","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol Exp"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patients with early-stage node-negative oral cancer undergo a sentinel lymph node biopsy (SLNB) or elective neck dissection under general anesthesia. A noninvasive imaging alternative would be of great interest. Superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) can visualize draining lymph nodes and potentially metastases. We investigated the optimal combination of SPIO injection and T2*-weighted MRI settings to identify the sentinel lymph nodes (SLNs), the lymphatic drainage pattern, and possibly to detect metastatic SLNs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      SPIO nanoparticles were injected submucosally around the primary tongue tumor in ten patients after routine SLNB imaging with indocyanine green-[\n                      <jats:sup>99m<\/jats:sup>\n                      Tc]Tc-nanocolloid, and MRI was performed 1\u2009h after injection. SPIO dose was adjusted for every two patients based on the imaging quality. Drainage patterns were compared between single-photon emission computed tomography (SPECT)\/computed tomography (CT) and MRI. MRI appearance of SLNs was compared to histopathology of resected nodes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One mg of iron was deemed a suitable dose after two dose alterations. All 25 SLNs observed on SPECT\/CT in eight patients were also identified on MRI. Including higher echelons, 55 lymph nodes were seen on SPECT\/CT, while 107 lymph nodes were seen on MRI. Eighteen lymph nodes showed a mixture of partial MRI signal attenuation and retention, which, when compared to histopathology, made discrimination between metastatic and nonmetastatic lymph nodes solely based on MRI impossible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SPIO-enhanced T2*-weighted MRI is suitable for mapping SLNs and lymphatic drainage pattern, showing significantly more lymph nodes compared to SPECT\/CT. Discriminating metastatic from nonmetastatic nodes does not seem feasible after SPIO injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      Clinicaltrials.gov NCT04803331. Registered 4 March 2021;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT04803331\" ext-link-type=\"uri\">https:\/\/clinicaltrials.gov\/study\/NCT04803331<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance statement<\/jats:title>\n                    <jats:p>SPIO-enhanced MRI seems noninferior to the current method of SLN detection with technetium, with better anatomical detail than SPECT\/CT: if proven comparable, SPIO-enhanced MRI could be considered a nonradioactive alternative with higher spatial resolution to define lymphatic drainage of tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>The use of superparamagnetic iron oxide (SPIO)-enhanced MRI in head and neck cancer is underassessed.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>SPIO-enhanced MRI detects nodal drainage patterns comparably to SPECT\/CT.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>SPIO-enhanced MRI does not discriminate lymph node metastases from false positives.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1186\/s41747-025-00636-4","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T16:44:16Z","timestamp":1763225056000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["SPIO-enhanced MRI for sentinel lymph node mapping in oral cancer: a prospective feasibility study"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4912-7806","authenticated-orcid":false,"given":"Gijs T. 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The study was registered in clinicaltrials.gov (NCT04803331).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of the images and data was obtained from the patient(s).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Patrik Z\u00e1mecnik declares to be a Scientific Advisor to SPL Medical B.V. and owner of SPL Medical B.V. stock\/options. The other authors declare that they have no conflicts of interest with the content of this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"113"}}