No abstract

This pilot study explored the value of localized index node removal after neoadjuvant immunotherapy in patients with stage III melanoma, for use as a response indicator to guide the extent of completion lymph node dissection. Promising technology

The position and orientation accuracy of a 6DOF sensor was comparable with a sensor configuration consisting of three 5DOF sensors. To achieve tracking accuracy within 1 mm and 1[Formula: see text], the distance to the TTFG should be limited to approximately 30 cm.

Wire‐guided localization (WGL) is the standard of care in the surgical treatment of nonpalpable breast tumors. In this study, we compare the use of a new magnetic marker localization (MaMaLoc) technique to WGL in the treatment of early‐stage breast cancer patients. Open‐label, single‐center, randomized controlled trial comparing MaMaLoc (intervention) to WGL (control) in women with early‐stage breast cancer. Primary outcome was surgical usability measured using the System Usability Scale (SUS, 0–100 score). Secondary outcomes were patient reported, clinical, and pathological outcomes such as retrieval rate, operative time, resected specimen weight, margin status, and reoperation rate. Thirty‐two patients were analyzed in the MaMaLoc group and 35 in the WGL group. Patient and tumor characteristics were comparable between groups. No in situ complications occurred. Retrieval rate was 100% in both groups. Surgical usability was higher for MaMaLoc: 70.2 ± 8.9 vs. 58.1 ± 9.1, p < 0.001. Patients reported higher overall satisfaction with MaMaLoc (median score 5/5) versus WGL (score 4/5), p < 0.001. The use of magnetic marker localization (MaMaLoc) for early‐stage breast cancer is effective and has higher surgical usability than standard WGL.

BACKGROUND AND PURPOSE:Aneurysm volume pulsation is a potential predictor of intracranial aneurysm rupture. We evaluated whether 7T MR imaging can quantify aneurysm volume pulsation.

No abstract

Background There is a transition from wire-guided localization (WGL) of non-palpable breast cancer to other localization techniques. Multiple prospective studies have sought to establish superior clinical outcomes for radioactive-seed localization (RSL), but consistent and congruent evidence is missing. Methods In this study, female patients with breast cancer operated with breast-conserving surgery after tumour localization of a non-palpable breast cancer or ductal carcinoma in situ (DCIS) were included. The cohort was identified from the nationwide Netherlands Breast Cancer Audit conducted between 2013 and 2018. Trends in localization techniques were analysed. Univariable and multivariable analyses were performed to assess the association between the localization technique and the probability of a reoperation. Results A total of 28 370 patients were included in the study cohort. The use of RSL increased from 15.7 to 61.1 per cent during the study years, while WGL decreased from 75.4 to 31.6 per cent. The localization technique used (RSL versus WGL) was not significantly associated with the odds of a reoperation, regardless of whether the lesion was DCIS (odds ratio 0.96 (95 per cent c.i. 0.89 to 1.03; P = 0.281)) or invasive breast cancer (OR 1.02 (95 per cent c.i. 0.96 to 1.10; P = 0.518)). Conclusion RSL is rapidly replacing WGL as the preoperative localization technique in breast surgery. This large nationwide registry study found no association between the type of localization technique and the odds of having a reoperation, thus confirming the results of previous prospective cohort studies.

For small, early-stage or otherwise non-palpable breast tumors, surgeons rely on localization technologies to accurately find and remove the tumor tissue during breast conserving surgery. However, current widely accepted localization technologies either use painful and logistically challenging guidewires, or complex radioactive iodine sources. We have developed an implantable magnetic marker, intended to mark the location of a breast tumor, that can be detected during surgery using a clinical handheld magnetic susceptometry system. Here, we report on the development and optimization of this magnetic marker, focusing on the material, shape and various material assemblies. It was found that the effects of magnetic shape anisotropy may decrease localization precision. This can be circumvented by combining multiple isotropic magnetic elements separated from one another. A final optimized prototype was constructed and compared to a commercially available magnetic marker. Finally, the technology was tested in an ex vivo surgical setting on tissue to assess radiological visibility and surgical feasibility. The marker was successfully detected and removed in all ex vivo sessions, and the technology was found feasible.