Alfonso Fausto1, Marco Bernini2, Daniele La Forgia3, Annarita Fanizzi3, Marco Marcasciano4, Luca Volterrani5, Donato Casella4, Maria Antonietta Mazzei5. 1. Department of Diagnostic Imaging, Azienda Ospedaliera Universitaria Senese, Viale Bracci 16, 53100, Siena, Italy. afausto@sirm.org. 2. Breast Unit, Department of Surgery, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy. 3. Department of Breast Radiology, IRCCS Istituto Tumori "Giovanni Paolo II", Viale Orazio Flacco, 65, 70124, Bari, Italy. 4. Breast Unit, Department of Surgery, Azienda U.S.L. Toscana Nord-Ovest, Hospital of Livorno, Via Vittorio Alfieri 36, 57124, Livorno, Italy. 5. Department of Medical, Surgical and Neuro Sciences, Diagnostic Imaging, University of Siena, Strada delle Scotte 2, 53100, Siena, Italy.
Abstract
OBJECTIVE: The aim of this study is to present a 6-year prospective evaluation of second-look ultrasound (US) using volume navigation (V Nav) for MRI-detected additional breast lesions. METHODS: After IRB approvals in both institutions, 1930 consecutive prone MRI breast examinations in 1437 patients were prospectively evaluated. All patients with an MRI-detected additional lesion underwent second-look US, and if occult, contrast-enhanced MRI in supine position was performed for US and MRI co-registration. For patients with breast hypertrophy, MRI-guided biopsy was performed directly. Pathologic examination was the standard of reference. One-way ANOVA and chi-square tests were used. RESULTS: In 490 MRI examinations (25.4%, 490/1930), at least one additional breast lesion was detected for a total of 722 only MRI-detected lesions. Second-look US identified 549 additional lesions (23 ± 8 mm); 362 (65.9%, 362/549) proved benign at pathology and 187 (34.1%, 187/549) malignant. Second-look US with V Nav identified 151 additional lesions (17 ± 9 mm, p = n.s.); 67 (44.4%, 67/151) proved benign at pathology and 84 (55.6%, 84/151) malignant. MRI-guided biopsy was performed on 22 additional breast lesions (22 ± 8 mm, p = n.s.); pathology revealed 20 (90.9%, 20/22) benign lesions and 2 (9.1%, 2/22) malignant ones. Mass lesions were significantly higher in the second-look US group (p < 0.001). No significant difference in lesion dimension was found between the three groups (p = 0.729). CONCLUSIONS: Second-look US with V Nav can be effective in detecting a large number of additional breast lesions occult at second-look US and to biopsy a significant number of malignant lesions safely and irrespective of distance from skin or lesion position. KEY POINTS: • Second-look US with volume navigation is effective in detecting occult additional lesions. • Permits safe biopsies irrespective of position and depth • Reduces the need for MRI-guided biopsy.
OBJECTIVE: The aim of this study is to present a 6-year prospective evaluation of second-look ultrasound (US) using volume navigation (V Nav) for MRI-detected additional breast lesions. METHODS: After IRB approvals in both institutions, 1930 consecutive prone MRI breast examinations in 1437 patients were prospectively evaluated. All patients with an MRI-detected additional lesion underwent second-look US, and if occult, contrast-enhanced MRI in supine position was performed for US and MRI co-registration. For patients with breast hypertrophy, MRI-guided biopsy was performed directly. Pathologic examination was the standard of reference. One-way ANOVA and chi-square tests were used. RESULTS: In 490 MRI examinations (25.4%, 490/1930), at least one additional breast lesion was detected for a total of 722 only MRI-detected lesions. Second-look US identified 549 additional lesions (23 ± 8 mm); 362 (65.9%, 362/549) proved benign at pathology and 187 (34.1%, 187/549) malignant. Second-look US with V Nav identified 151 additional lesions (17 ± 9 mm, p = n.s.); 67 (44.4%, 67/151) proved benign at pathology and 84 (55.6%, 84/151) malignant. MRI-guided biopsy was performed on 22 additional breast lesions (22 ± 8 mm, p = n.s.); pathology revealed 20 (90.9%, 20/22) benign lesions and 2 (9.1%, 2/22) malignant ones. Mass lesions were significantly higher in the second-look US group (p < 0.001). No significant difference in lesion dimension was found between the three groups (p = 0.729). CONCLUSIONS: Second-look US with V Nav can be effective in detecting a large number of additional breast lesions occult at second-look US and to biopsy a significant number of malignant lesions safely and irrespective of distance from skin or lesion position. KEY POINTS: • Second-look US with volume navigation is effective in detecting occult additional lesions. • Permits safe biopsies irrespective of position and depth • Reduces the need for MRI-guided biopsy.
Entities:
Keywords:
Breast tumours; Breast ultrasonography; Image-guided biopsy; Magnetic resonance imaging; Multimodal imaging
Authors: Maria Antonietta Mazzei; Letizia Di Giacomo; Alfonso Fausto; Francesco Gentili; Francesco Giuseppe Mazzei; Luca Volterrani Journal: Biomed Res Int Date: 2018-10-21 Impact factor: 3.411