Benedict Krischer1, Serafino Forte2, Tilo Niemann2, Rahel A Kubik-Huch2, Cornelia Leo3. 1. Department of Gynecology, Breast Center, Kantonsspital Baden, Switzerland. 2. Department of Radiology, Kantonsspital Baden, Switzerland. 3. Department of Gynecology, Breast Center, Kantonsspital Baden, Switzerland. Electronic address: cornelia.leo@ksb.ch.
Abstract
RATIONALE: The gold standard for detection of axillary sentinel lymph nodes uses injection of a radioisotope (99Tc Nanocoll). As an alternative to this method, a magnetometer detecting the superparamagnetic tracer Sienna+® can be applied for detection of sentinel lymph nodes. The goal of this study was to determine whether interpretation of breast MRI is impaired by Sienna+® tracer residues in the operated breast and axillary lymph nodes after a sentinel procedure using this tracer. PATIENTS AND METHODS: 34 patients who received the Sienna+® tracer for marking the sentinel node were invited to undergo a follow-up breast MRI. Native MR images were obtained from breast and axilla. The breast MRIs were evaluated by two independent breast radiologists for Sienna+® tracer related artefacts and for the degree of impairment of the MR imaging. RESULTS: 24 of the 34 invited patients took part in this study. The mean time since injection of Sienna+® was 42 months (40.6-45.4 months). Two patients had bilateral surgery with injections in both breasts, leading to a total of 26 separate cases. One case had to be excluded due to breathing artefacts. In 10 cases (40%), impaired imaging was found. In three cases (12%), the MRI scan reading was impossible due to Sienna+® tracer residues, the other 12 cases (48%) showed no restriction. In the subgroup of patients treated with breast conserving surgery, tracer residue artefacts were found in 13 of 17 patients (76.5%). CONCLUSION: To our knowledge, in this study for the first time MR feasibility after Sienna injection was investigated. Sienna+® impaired breast MRI after a mean follow-up time of 42 months in half of the cases. Further research is needed to investigate time and field-strength dependency of tracer detectability as well as the diagnostic impact of these artifacts on contrast-enhanced imaging in a clinical setting.
RATIONALE: The gold standard for detection of axillary sentinel lymph nodes uses injection of a radioisotope (99Tc Nanocoll). As an alternative to this method, a magnetometer detecting the superparamagnetic tracer Sienna+® can be applied for detection of sentinel lymph nodes. The goal of this study was to determine whether interpretation of breast MRI is impaired by Sienna+® tracer residues in the operated breast and axillary lymph nodes after a sentinel procedure using this tracer. PATIENTS AND METHODS: 34 patients who received the Sienna+® tracer for marking the sentinel node were invited to undergo a follow-up breast MRI. Native MR images were obtained from breast and axilla. The breast MRIs were evaluated by two independent breast radiologists for Sienna+® tracer related artefacts and for the degree of impairment of the MR imaging. RESULTS: 24 of the 34 invited patients took part in this study. The mean time since injection of Sienna+® was 42 months (40.6-45.4 months). Two patients had bilateral surgery with injections in both breasts, leading to a total of 26 separate cases. One case had to be excluded due to breathing artefacts. In 10 cases (40%), impaired imaging was found. In three cases (12%), the MRI scan reading was impossible due to Sienna+® tracer residues, the other 12 cases (48%) showed no restriction. In the subgroup of patients treated with breast conserving surgery, tracer residue artefacts were found in 13 of 17 patients (76.5%). CONCLUSION: To our knowledge, in this study for the first time MR feasibility after Sienna injection was investigated. Sienna+® impaired breast MRI after a mean follow-up time of 42 months in half of the cases. Further research is needed to investigate time and field-strength dependency of tracer detectability as well as the diagnostic impact of these artifacts on contrast-enhanced imaging in a clinical setting.
Authors: Sina Shams; Kai Lippold; Jens Uwe Blohmer; Robert Röhle; Friedrich Kühn; Maria Margarete Karsten Journal: Ann Surg Oncol Date: 2020-12-01 Impact factor: 5.344
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Authors: Anke Christenhusz; Joost J Pouw; Frank F J Simonis; Michael Douek; Muneer Ahmed; Joost M Klaase; Anneriet E Dassen; Caroline A H Klazen; Margreet C van der Schaaf; Bernard Ten Haken; Lejla Alic Journal: Eur Radiol Exp Date: 2022-01-27