Juan Li1, Hui Li2, Ling Guan3, Yun Lu3, Weiwei Zhan4, Yijie Dong4, Peng Gu5, Jian Liu5, Wen Cheng6, Ziyue Na6, Lina Tang7, Zhongshi Du7, Lichun Yang8, Saiping Hai8, Chen Yang9, Qingqiu Zheng9, Yuhua Zhang10, Shan Wang10, Fang Li11, Jing Fu11, Man Lu12. 1. Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, No.55, Section 4, South Renmin Road, Chengdu, China. 2. Breast Surgeons Department, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China. 3. Ultrasound Medical Center, Gansu Cancer Hospital, Lanzhou, China. 4. Ultrasound Medical Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 5. Ultrasound Medical Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China. 6. Ultrasound Medical Center, the Affiliated Tumor Hospital of Harbin Medical University, Harbin, China. 7. Ultrasound Medical Center, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, People's Republic of China. 8. Ultrasound Medical Center, Yunnan Cancer Hospital, Kunming, China. 9. Ultrasound Medical Center, Zhejiang Cancer Hospital, Hangzhou, 310022, China. 10. Ultrasound Medical Center, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China. 11. Ultrasound Medical Center, Chongqing Cancer Hospital and Cancer Institute, Chongqing, China. 12. Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, No.55, Section 4, South Renmin Road, Chengdu, China. graceof@163.com.
Abstract
OBJECTIVE: The study conducted a multicenter study in China to explore the learning curve of contrast enhanced ultrasound (CEUS) for sentinel lymph nodes (SLNs), the feasibility of using this technique for the localization of SLNs and lymphatic channels (LCs) and its diagnostic performance for lymph node metastasis. METHOD: Nine hundred two patients with early invasive breast cancer from six tertiary class hospitals in China were enrolled between December 2016 and December 2019. Each patient received general ultrasound scanning and SLN-CEUS before surgery. The locations and sizes of LCs and SLNs were marked on the body surface based on observations from SLN-CEUS. These body surface markers were then compared with intraoperative blue staining in terms of their locations. The first 40 patients from each center were included in determining the learning curve of SLN-CEUS across sites. The remaining patients were used to investigate the diagnostic efficacy of this technique in comparison with intraoperative blue staining and pathology respectively. RESULT: The ultrasound doctor can master SLN-CEUS after 25 cases, and the mean operating time is 22.5 min. The sensitivity, specificity, negative predictive value, and positive predictive value of SLN-CEUS in diagnosing lymph node metastases were 86.47, 89.81, 74.90, and 94.97% respectively. CONCLUSION: Ultrasound doctors can master SLN-CEUS with a suitable learning curve. SLN-CEUS is a feasible and useful approach to locate SLNs and LCs before surgery and it is helpful for diagnosing LN metastases.
OBJECTIVE: The study conducted a multicenter study in China to explore the learning curve of contrast enhanced ultrasound (CEUS) for sentinel lymph nodes (SLNs), the feasibility of using this technique for the localization of SLNs and lymphatic channels (LCs) and its diagnostic performance for lymph node metastasis. METHOD: Nine hundred two patients with early invasive breast cancer from six tertiary class hospitals in China were enrolled between December 2016 and December 2019. Each patient received general ultrasound scanning and SLN-CEUS before surgery. The locations and sizes of LCs and SLNs were marked on the body surface based on observations from SLN-CEUS. These body surface markers were then compared with intraoperative blue staining in terms of their locations. The first 40 patients from each center were included in determining the learning curve of SLN-CEUS across sites. The remaining patients were used to investigate the diagnostic efficacy of this technique in comparison with intraoperative blue staining and pathology respectively. RESULT: The ultrasound doctor can master SLN-CEUS after 25 cases, and the mean operating time is 22.5 min. The sensitivity, specificity, negative predictive value, and positive predictive value of SLN-CEUS in diagnosing lymph node metastases were 86.47, 89.81, 74.90, and 94.97% respectively. CONCLUSION: Ultrasound doctors can master SLN-CEUS with a suitable learning curve. SLN-CEUS is a feasible and useful approach to locate SLNs and LCs before surgery and it is helpful for diagnosing LN metastases.
Authors: A Nielsen Moody; J Bull; A-M Culpan; T Munyombwe; N Sharma; M Whitaker; S Wolstenhulme Journal: Clin Radiol Date: 2017-08-01 Impact factor: 2.350
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Authors: Francesco Giammarile; Naomi Alazraki; John N Aarsvold; Riccardo A Audisio; Edwin Glass; Sandra F Grant; Jolanta Kunikowska; Marjut Leidenius; Valeria M Moncayo; Roger F Uren; Wim J G Oyen; Renato A Valdés Olmos; Sergi Vidal Sicart Journal: Eur J Nucl Med Mol Imaging Date: 2013-10-02 Impact factor: 9.236