A Sever1, S Jones, K Cox, J Weeks, P Mills, P Jones. 1. Department of Radiology, Maidstone Hospital Breast Clinic, The Maidstone Hospital, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK. ali.sever@nhs.net
Abstract
BACKGROUND: Sentinel lymph node (SLN) biopsy is the standard procedure for axillary staging in early breast cancer. Lymphatic imaging after intraparenchymal microbubble injection has been reported in animal models. The aim of this study was to identify and localize SLNs before surgery by contrast-enhanced ultrasonography after intradermal injection of microbubbles in patients with breast cancer. METHODS: Fifty-four consecutive, consenting patients with primary breast cancer were recruited. Patients received a periareolar intradermal injection of microbubble contrast agent. Breast lymphatics were visualized by ultrasonography and followed to identify putative axillary SLNs. A guidewire was deployed to localize the SLN. The next day, patients underwent standard tumour excision and SLN biopsy. RESULTS: SLNs were identified and guidewires inserted in 48 patients. In these patients operative findings confirmed that the wired lymph nodes were SLNs. The sensitivity of SLN detection, compared with radioisotope and blue dye, was 89 per cent. Five patients were found to have metastases in SLNs. In these patients the SLNs were identified correctly and localized before surgery with guidewires. CONCLUSION: SLNs may be identified and localized before surgery using contrast-enhanced ultrasonography after injection of microbubbles.
BACKGROUND: Sentinel lymph node (SLN) biopsy is the standard procedure for axillary staging in early breast cancer. Lymphatic imaging after intraparenchymal microbubble injection has been reported in animal models. The aim of this study was to identify and localize SLNs before surgery by contrast-enhanced ultrasonography after intradermal injection of microbubbles in patients with breast cancer. METHODS: Fifty-four consecutive, consenting patients with primary breast cancer were recruited. Patients received a periareolar intradermal injection of microbubble contrast agent. Breast lymphatics were visualized by ultrasonography and followed to identify putative axillary SLNs. A guidewire was deployed to localize the SLN. The next day, patients underwent standard tumour excision and SLN biopsy. RESULTS: SLNs were identified and guidewires inserted in 48 patients. In these patients operative findings confirmed that the wired lymph nodes were SLNs. The sensitivity of SLN detection, compared with radioisotope and blue dye, was 89 per cent. Five patients were found to have metastases in SLNs. In these patients the SLNs were identified correctly and localized before surgery with guidewires. CONCLUSION: SLNs may be identified and localized before surgery using contrast-enhanced ultrasonography after injection of microbubbles.
Authors: Xin-Wu Cui; Christian Jenssen; Adrian Saftoiu; Andre Ignee; Christoph F Dietrich Journal: World J Gastroenterol Date: 2013-08-14 Impact factor: 5.742
Authors: Ali R Sever; Philippa Mills; Jean-Marc Hyvelin; Jennifer Weeks; Hatice Gumus; David Fish; Willem Mali; Susan E Jones; Peter A Jones; Haresh Devalia Journal: Eur Radiol Date: 2011-10-07 Impact factor: 5.315
Authors: Ji-Bin Liu; Daniel A Merton; Adam C Berger; Flemming Forsberg; Agnieszka Witkiewicz; Hongjia Zhao; John R Eisenbrey; Traci B Fox; Barry B Goldberg Journal: J Ultrasound Med Date: 2014-06 Impact factor: 2.153
Authors: O Lahtinen; M Eloranta; M Anttila; H Kärkkäinen; R Sironen; R Vanninen; S Rautiainen Journal: Eur Radiol Date: 2017-11-30 Impact factor: 5.315