PURPOSE: To investigate magnetic resonance image-guided high intensity focused ultrasound (MR-HIFU) as a surgical guide for nonpalpable breast tumors by assessing the palpability of MR-HIFU-created lesions in ex vivo cadaveric breast tissue. MATERIALS AND METHODS: MR-HIFU ablations spaced 5 mm apart were made in 18 locations using the ExAblate2000 system. Ablations formed a square perimeter in mixed adipose and fibroglandular tissue. Ablation was monitored using T1-weighted fast spin echo images. MR-acoustic radiation force impulse (MR-ARFI) was used to remotely palpate each ablation location, measuring tissue displacement before and after thermal sonications. Displacement profiles centered at each ablation spot were plotted for comparison. The cadaveric breast was manually palpated to assess stiffness of ablated lesions and dissected for gross examination. This study was repeated on three cadaveric breasts. RESULTS: MR-ARFI showed a collective postablation reduction in peak displacement of 54.8% ([4.41 ± 1.48] μm pre, [1.99 ± 0.82] μm post), and shear wave velocity increase of 65.5% ([10.69 ± 1.60] mm pre, [16.33 ± 3.10] mm post), suggesting tissue became stiffer after the ablation. Manual palpation and dissection of the breast showed increased palpability, a darkening of ablation perimeter, and individual ablations were visible in mixed adipose/fibroglandular tissue. CONCLUSION: The results of this preliminary study show MR-HIFU has the ability to create palpable lesions in ex vivo cadaveric breast tissue, and may potentially be used to preoperatively localize nonpalpable breast tumors.
PURPOSE: To investigate magnetic resonance image-guided high intensity focused ultrasound (MR-HIFU) as a surgical guide for nonpalpable breast tumors by assessing the palpability of MR-HIFU-created lesions in ex vivo cadaveric breast tissue. MATERIALS AND METHODS: MR-HIFU ablations spaced 5 mm apart were made in 18 locations using the ExAblate2000 system. Ablations formed a square perimeter in mixed adipose and fibroglandular tissue. Ablation was monitored using T1-weighted fast spin echo images. MR-acoustic radiation force impulse (MR-ARFI) was used to remotely palpate each ablation location, measuring tissue displacement before and after thermal sonications. Displacement profiles centered at each ablation spot were plotted for comparison. The cadaveric breast was manually palpated to assess stiffness of ablated lesions and dissected for gross examination. This study was repeated on three cadaveric breasts. RESULTS: MR-ARFI showed a collective postablation reduction in peak displacement of 54.8% ([4.41 ± 1.48] μm pre, [1.99 ± 0.82] μm post), and shear wave velocity increase of 65.5% ([10.69 ± 1.60] mm pre, [16.33 ± 3.10] mm post), suggesting tissue became stiffer after the ablation. Manual palpation and dissection of the breast showed increased palpability, a darkening of ablation perimeter, and individual ablations were visible in mixed adipose/fibroglandular tissue. CONCLUSION: The results of this preliminary study show MR-HIFU has the ability to create palpable lesions in ex vivo cadaveric breast tissue, and may potentially be used to preoperatively localize nonpalpable breast tumors.
Authors: Kim Butts Pauly; Chris J Diederich; Viola Rieke; Donna Bouley; Jing Chen; Will H Nau; Anthony B Ross; Adam M Kinsey; Graham Sommer Journal: Top Magn Reson Imaging Date: 2006-06
Authors: Annemarie C Schmitz; Maurice A A J van den Bosch; Viola Rieke; Frederick M Dirbas; Kim Butts Pauly; Willem P Th M Mali; Bruce L Daniel Journal: J Magn Reson Imaging Date: 2009-10 Impact factor: 4.813
Authors: F Izzo; R Thomas; P Delrio; M Rinaldo; P Vallone; A DeChiara; G Botti; G D'Aiuto; P Cortino; S A Curley Journal: Cancer Date: 2001-10-15 Impact factor: 6.860
Authors: Michael H Wang; Mark L Palmeri; Cynthia D Guy; Liu Yang; Laurence W Hedlund; Anna Mae Diehl; Kathryn R Nightingale Journal: Ultrasound Med Biol Date: 2009-08-14 Impact factor: 2.998
Authors: Allison Payne; Josh de Bever; Alexis Farrer; Brittany Coats; Dennis L Parker; Douglas A Christensen Journal: Med Phys Date: 2015-02 Impact factor: 4.071
Authors: Pooja Gaur; Kerriann M Casey; Jan Kubanek; Ningrui Li; Morteza Mohammadjavadi; Yamil Saenz; Gary H Glover; Donna M Bouley; Kim Butts Pauly Journal: Brain Stimul Date: 2020-02-21 Impact factor: 8.955
Authors: Lorne W Hofstetter; Henrik Odéen; Bradley D Bolster; Alexander Mueller; Douglas A Christensen; Allison Payne; Dennis L Parker Journal: Magn Reson Med Date: 2019-01-21 Impact factor: 4.668