Evidence map›Paper›PMID 40841783›Full record

Trial reportEuropean radiology2026

Preoperative contrast-enhanced ultrasound combined with intra-lymph node methylene blue injection for sentinel lymph node identification: a minimally invasive sentinel lymph node biopsy tracing approach.

Yang Liu, Jian Wu, Wenjie Zhang, Tielin Wang, Shuang Wu, Hong Zhou, Yang Zhou, Ying Liu

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yang LiuDepartment of Ultrasound, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Jian WuDepartment of Breast and Thyroid Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Wenjie ZhangDepartment of Breast and Thyroid Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Tielin WangDepartment of Breast and Thyroid Surgery, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Shuang WuDepartment of Ultrasound, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Hong ZhouDepartment of Ultrasound, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China.
Yang ZhouDepartment of Ultrasound, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China. zhouyang@swjtu.edu.cn.
Ying LiuDepartment of Ultrasound, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, China. liuying@swjtu.edu.cn.ORCID http://orcid.org/0000-0002-7666-8459

Funding

Key Research and Development Program of Sichuan Province 2024YFHZ0078Natural Science Youth Fund Project of the Sichuan Provincial Department of Science and Technology 2024NSFSC1781Special Clinical Research Project of the Sichuan Provincial Health Commission 23LCYJ039The Third People's Hospital of Chengdu Scientific Research Project CSY-YN-01-2023-004, 2023PI03
6 · The paper itself

Abstract

objectivesTo investigate the significance of preoperative contrast-enhanced ultrasound (CEUS) coupled with injections of methylene blue (MB) into the lymph nodes, alongside intracutaneous injections of indocyanine green (ICG) for sentinel lymph node (SLN) identification in early breast cancer. MATERIALS AND

methodsAll patients from a single institution were prospectively randomized into two groups: CEUS Group (preoperative SLN-CEUS coupled with injections of MB into the lymph nodes, with ICG intracutaneous injections for SLN identification during surgery) and Blue Staining Group (intracutaneous injections of both ICG and MB for SLN mapping during surgery). Pathological results served as the gold standard. Multivariate logistic regression analysis was used to identify independent risk factors for SLN metastasis. Areas under the receiver-operating characteristic curve (AUC) were used to evaluate the ability of CEUS to diagnose SLN metastasis.

results134 patients were enrolled (CEUS Group: 76 patients, Blue Staining Group: 58 patients). CEUS Group achieved a 100.0% success rate in detecting SLNs, with identifying a median of 1 SLN, while Blue Staining Group identifying a median of 4 SLNs per case (p < 0.001). CEUS enhancement pattern was the only factor independently linked to SLN metastasis (p < 0.001), showing a sensitivity of 90.5% and a specificity of 94.5%. The AUC for identifying SLN metastasis was 0.925.

conclusionsCEUS enhancement pattern is helpful to determine the SLN metastasis. Preoperative CEUS, combined with MB injections into lymph nodes and intracutaneous ICG injections during surgery, provides a reliable method for localizing SLNs. This approach minimizes the risk of non-SLNs excisions. KEY POINTS: Question Despite the critical role of sentinel lymph node (SLN) detection in surgical outcomes, current preoperative imaging-guided SLN tracing remains in the exploratory stage. Findings Contrast-enhanced (CE) US achieved 100% SLN detection success with fewer non-target lymph nodes excised versus blue dye, demonstrating superior sensitivity and specificity metastatic prediction. Clinical relevance Preoperative SLN-CEUS, combined with intralymphatic methylene blue injection and intracutaneous indocyanine green administration during surgery, enables precise SLN identification and metastasis prediction. This approach minimizes the risk of unnecessary non-SLN resection during SLNB.

Indexed as

Breast NeoplasmsMethylene BlueSentinel Lymph NodeSentinel Lymph Node BiopsyUltrasonography, MammaryAdultAgedContrast MediaFemaleHumansIndocyanine GreenLymphatic MetastasisMiddle AgedPreoperative CareProspective StudiesSensitivity and SpecificityContrast MediaIndocyanine GreenMethylene BlueBreast cancerContrast agentSentinel lymph node biopsyUltrasonography

Identifiers

PMID40841783
PMCPMC12953311

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.