Magnetic resonance imaging-radioguided occult lesion localization (ROLL) in breast cancer using Tc-99m macro-aggregated albumin and distilled water control

BMC Medical Imaging

Lea Mirian Barbosa da Fonseca²  Emerson Leandro Gasparetto³  Maria Veronica Fonseca Torres de Oliveira²  Maria Julia Gregorio Calas¹  Gabriela Martins³  Fernanda Philadelpho Arantes Pereira³ 

[1] Department of Breast Imaging, Clínica de Diagnóstico por Imagem (CDPI), Av. Ataulfo de Paiva 669, 2nd floor, Leblon, Rio de Janeiro, RJ 22440-032, Brazil;Department of Nuclear Medicine, Clínica de Diagnóstico por Imagem (CDPI), Av. Ataulfo de Paiva 669, 2nd floor, Leblon, Rio de Janeiro, RJ 22440-032, Brazil;Department of Magnetic Resonance Imaging, Clínica de Diagnóstico por Imagem (CDPI), Av. Ataulfo de Paiva 669, 2nd floor, Leblon, Rio de Janeiro, RJ 22440-032, Brazil

关键词: Breast cancer;    Radioisotopes;    Nuclear medicine;    MR-guided interventional procedures;    Magnetic resonance imaging (MRI);   

Others  :  1090522
DOI  :  10.1186/1471-2342-13-33

 received in 2012-09-10, accepted in 2013-09-11,  发布年份 2013

【 摘 要 】

Background

Magnetic resonance imaging (MRI) guided wire localization presents several challenges apart from the technical difficulties. An alternative to this conventional localization method using a wire is the radio-guided occult lesion localization (ROLL), more related to safe surgical margins and reductions in excision volume. The purpose of this study was to establish a safe and reliable magnetic resonance imaging-radioguided occult lesion localization (MRI-ROLL) technique and to report our initial experience with the localization of nonpalpable breast lesions only observed on MRI.

Methods

Sixteen women (mean age 53.2 years) with 17 occult breast lesions underwent radio-guided localization in a 1.5-T MR system using a grid-localizing system. All patients had a diagnostic MRI performed prior to the procedure. An intralesional injection of Technetium-99m macro-aggregated albumin followed by distilled water was performed. After the procedure, scintigraphy was obtained. Surgical resection was performed with the help of a gamma detector probe. The lesion histopathology and imaging concordance; the procedure’s positive predictive value (PPV), duration time, complications, and accuracy; and the rate of exactly excised lesions evaluated with MRI six months after the surgery were assessed.

Results

One lesion in one patient had to be excluded because the radioactive substance came back after the injection, requiring a wire placement. Of the remaining cases, there were four malignant lesions, nine benign lesions, and three high-risk lesions. Surgical histopathology and imaging findings were considered concordant in all benign and high-risk cases. The PPV of MRI-ROLL was greater if the indication for the initial MR examination was active breast cancer. The median procedure duration time was 26 minutes, and all included procedures were defined as accurate. The exact and complete lesion removal was confirmed in all (100%) patients who underwent six-month postoperative MRI (50%).

Conclusions

MRI-ROLL offers a precise, technically feasible, safe, and rapid means for performing preoperative MRI localizations in the breast.

【 授权许可】

   
2013 Philadelpho Arantes Pereira et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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