Magnetic resonance imaging-guided occult breast lesion localization and simultaneous sentinel lymph node mapping

Abstract

BackgroundRadio-guided occult lesion localization is a valid technique for the diagnosis of suspicious non-palpable lesions. Here we determine the feasibility of pre-operative localization of occult suspect non-palpable breast lesions using radio-guided occult lesion localization, as well as for identifying the sentinel lymph node.MethodsThis is a descriptive study of data collected retrospectively. Pre-operative mapping of 34 breast lesions in 25 patients suspected of being malignant was performed using conventional imaging methods with a magnetic resonance imaging-guided radiopharmaceutical injection.ResultsThe mean time required to perform the localization was 25 minutes. After resection of the lesions using a gamma probe, malignancy was confirmed in fifteen patients (60.0%), with nine invasive ductal carcinomas, two invasive lobular carcinomas, and four in situ ductal carcinomas The resection was confirmed by the complete removal of the radioactive material. The pathologic results and images were concordant in all but two cases, which were submitted for new magnetic resonance imaging examinations and surgery that confirmed the malignancies. Of the 15 patients with confirmed malignancies, 10 had sentinel lymph node resection. Of these, eight were negative for metastases, one had micro-metastases and one had confirmed metastases. Three patients had full axillary node dissection, with metastases found in only one. No side effects were observed with magnetic resonance-guided radiopharmaceutical injection.ConclusionsThe sentinel node occult lesion localization technique is a simple, reproducible and effective alternative approach to occult lesions compared to other methods, such as mammotomy and the hook-wire localization technique, for mapping suspect breast lesions and identifying lymph node metastasis.

Magnetic Probe–Guided Excision of Nonpalpable Neck Lesions

“…These properties include their high surface-to-volume ratio, quantum properties, and ability to carry other compounds because of their small size. 10,11 We therefore aimed to determine the feasibility of using iron oxide magnetic nanoparticles for the localization of nonpalpable neck lesions in patients with previously operated neck compartments. Such a technique could also provide access to nonpalpable lesion localization in centers without readily available access to nuclear medicine facilities.…”

“…Magnetic sentinel node and occult lesion localization in breast cancer has been described for breast lesions 10-13 but was not used in the excision of nonpalpable lesions in patients with previously operated neck compartments.…”

Recent Progress for the Techniques of MRI-Guided Breast Interventions and their applications on Surgical Strategy

“…These new technologies can relieve the pressures of the number of same-day requests for diagnostic localization or biopsy of breast imaging centers, as well as increase patients' convenience and comfort. However, these newer techniques cannot be placed under MRI guidance, and to date only wire localizations can be performed under MRI guidance [75][76][77][78][79][80][81].…”